Active substances: Ivermectin
The effect is dose-dependent. Moreover, the resulting decline in mosquito populations can boost the effects of core vector control tools i. The community delivery of ivermectin has the potential to fill an important gap in vector control by addressing residual transmission.
In addition to tackling residual transmission, ivermectin belongs to a different chemical class than the active ingredients present in ITNs or sprays, potentially contributing to insecticide resistance management.
Such properties place ivermectin MDA as an attractive addition to the malaria control toolbox.
However, before deployment, key questions regarding the delivery of this drug will need to be answered, including the determination of the range of effective and safe doses, the target population, the required level of community uptake, the malaria epidemiologic context, and the distribution strategies, among others.
Given the considerable effort associated with the high-level community delivery of a relatively short-acting drug, the use of ivermectin could be suitable for short and intense use, as opposed to the more enduring use of other measures such as ITNs.
Ivermectin MDA combined with antimalarial drugs to simultaneously clear infections in humans, provide time-limited chemoprevention, and prevent transmission, increasing impact.
Although the target populations of SMC and ivermectin MDA differ, the latter could benefit from the current door-to-door delivery strategy of SMC to children in households, to also deliver ivermectin to the rest of the eligible population.
The need to deliver as part of a combination regimen for LF, varying dosages across programs, and different sources of ivermectin need to be rationalized where joint programming is considered.
Physiological resistance among both head and body louse populations to lindane is widespread.
These two organochlorides are neurotoxic for parasites.Wien Klin Wochenschr.
Due to developed resistance and safety concerns, the use of these products should be discussed. An organophosphorous insecticide formulated in concentrations of 1.
It worked rapidly against adult lice and was usually effective ovicide. Its effectiveness has been tested in clinical trials. However, resistance of body lice to malathion has been reported in Burundi and Ethiopia. In France, head lice resistance to malathion is reported to be based on clinical failure to control infestations.
In addition, a randomized study in 22 volunteers found no evidence that malathion was dangerous in the treatment of head lice when the products were applied in accordance with the instructions for use.
However, its use in children under 6 months should be avoided. Used since 1976, more recent reviews have reported carbaryl to be less effective than previously thought.
Potentially carcinogenic in rodents, its prescription was restricted in UK. These pyrethroids are closely related to permethrin and are combined with a synergist piperonyl butoxide or nonsynergist insecticide permethrin.
Like malathion, these products can be a fire danger, and burns have been reported. As with permethrin, resistance to this compound has already appeared in France, UK, and the Czech Republic.
In clinical trials, phenothrin has been demonstrated to also be more effective than wet-combing.