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Kositz C, Bradley J, Hutchins H, Last A, D'Alessandro U, Marks M. Broadening the range of use cases for ivermectin - a review of the evidence. Trans R Soc Trop Med Hyg 2021; 116:201-212. [PMID: 34323283 DOI: 10.1093/trstmh/trab114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/12/2022] Open
Abstract
Ivermectin is a broad-spectrum antiparasitic agent that interferes with glutamate-gated chloride channels found in invertebrates but not in vertebrate species. Mass drug administration (MDA) with ivermectin-based regimes has been a mainstay of elimination efforts targeting onchocerciasis and lymphatic filariasis for more than 3 decades. More recently, interest in the use of ivermectin to control other neglected tropical diseases (NTDs) such as soil-transmitted helminths and scabies has grown. Interest has been further stimulated by the fact that ivermectin displays endectocidal efficacy against various Anopheles species capable of transmitting malaria. Therefore there is growing interest in using ivermectin MDA as a tool that might aid in the control of both malaria and several NTDs. In this review we outline the evidence base to date on these emerging indications for ivermectin MDA with reference to clinical and public health data and discuss the rationale for evaluating the range of impacts of a malaria ivermectin MDA on other NTDs.
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Affiliation(s)
- Christian Kositz
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - John Bradley
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Harry Hutchins
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Anna Last
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.,Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
| | - Umberto D'Alessandro
- Disease Control and Elimination, Medical Research Council Unit Gambia at London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.,Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
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High concentrations of membrane-fed ivermectin are required for substantial lethal and sublethal impacts on Aedes aegypti. Parasit Vectors 2021; 14:9. [PMID: 33407825 PMCID: PMC7789309 DOI: 10.1186/s13071-020-04512-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/01/2020] [Indexed: 12/25/2022] Open
Abstract
Background With widespread insecticide resistance in mosquito vectors, there is a pressing need to evaluate alternatives with different modes of action. Blood containing the antihelminthic drug ivermectin has been shown to have lethal and sub-lethal effects on mosquitoes. Almost all work to date has been on Anopheles spp., but impacts on other anthropophagic vectors could provide new options for their control, or additional value to anti-malarial ivermectin programmes. Methods Using dose-response assays, we evaluated the effects of ivermectin delivered by membrane feeding on daily mortality (up to 14 days post-blood feed) and fecundity of an Indian strain of Aedes aegypti. Results The 7-day lethal concentration of ivermectin required to kill 50% of adult mosquitoes was calculated to be 178.6 ng/ml (95% confidence intervals 142.3–218.4) for Ae. aegypti, which is much higher than that recorded for Anopheles spp. in any previous study. In addition, significant effects on fecundity and egg hatch rates were only recorded at high ivermectin concentrations (≥ 250 ng/ul). Conclusion Our results suggest that levels of ivermectin present in human blood at current dosing regimes in mass drug administration campaigns, or even those in a recent higher-dose anti-malaria trial, are unlikely to have a substantial impact on Ae. aegypti. Moreover, owing to the strong anthropophagy of Ae. aegypti, delivery of higher levels of ivermectin in livestock blood is also unlikely to be an effective option for its control. However, other potential toxic impacts of ivermectin metabolites, accumulation in tissues, sublethal effects on behaviour, or antiviral action might increase the efficacy of ivermectin against Ae. aegypti and the arboviral diseases it transmits, and require further investigation.![]()
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Repurposing Drugs to Fight Hepatic Malaria Parasites. Molecules 2020; 25:molecules25153409. [PMID: 32731386 PMCID: PMC7435416 DOI: 10.3390/molecules25153409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/16/2022] Open
Abstract
Malaria remains one of the most prevalent infectious diseases worldwide, primarily affecting some of the most vulnerable populations around the globe. Despite achievements in the treatment of this devastating disease, there is still an urgent need for the discovery of new drugs that tackle infection by Plasmodium parasites. However, de novo drug development is a costly and time-consuming process. An alternative strategy is to evaluate the anti-plasmodial activity of compounds that are already approved for other purposes, an approach known as drug repurposing. Here, we will review efforts to assess the anti-plasmodial activity of existing drugs, with an emphasis on the obligatory and clinically silent liver stage of infection. We will also review the current knowledge on the classes of compounds that might be therapeutically relevant against Plasmodium in the context of other communicable diseases that are prevalent in regions where malaria is endemic. Repositioning existing compounds may constitute a faster solution to the current gap of prophylactic and therapeutic drugs that act on Plasmodium parasites, overall contributing to the global effort of malaria eradication.
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Siewe Fodjo JN, Kugler M, Hotterbeekx A, Hendy A, Van Geertruyden JP, Colebunders R. Would ivermectin for malaria control be beneficial in onchocerciasis-endemic regions? Infect Dis Poverty 2019; 8:77. [PMID: 31439040 PMCID: PMC6706915 DOI: 10.1186/s40249-019-0588-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is accumulating evidence supporting the use of ivermectin as a malaria control tool. Recent findings from the repeat ivermectin mass drug administrations for control of malaria trial demonstrated a reduced incidence of malaria in villages which received repeated ivermectin mass drug administration (MDA; six doses) compared to those who had only one round of ivermectin. Several other studies investigating the benefits of ivermectin for malaria purposes are ongoing/planned. MAIN TEXT While ivermectin MDA offers promising perspectives in the fight against malaria, we highlight the added benefits and anticipated challenges of conducting future studies in onchocerciasis-endemic regions, which are confronted with a substantial disease burden including onchocerciasis-associated epilepsy. Increasing the frequency of ivermectin MDA in such places may reduce the burden of both malaria and onchocerciasis, and allow for more entomological investigations on both the Anopheles mosquitoes and the blackflies. Upfront, acceptability and feasibility studies are needed to assess the endorsement by the local populations, as well as the programmatic feasibility of implementing ivermectin MDA several times a year. CONCLUSIONS Onchocerciasis-endemic sites would doubly benefit from ivermectin MDA interventions, as these will alleviate onchocerciasis-associated morbidity and mortality, while potentially curbing malaria transmission. Involving onchocerciasis programs and other relevant stakeholders in the malaria/ivermectin research agenda would foster the implementation of pluri-annual MDA in target communities.
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Affiliation(s)
- Joseph Nelson Siewe Fodjo
- Global Health Institute, University of Antwerp, Kinsbergen centrum, Doornstraat 331, 2610, Antwerp, Belgium
| | - Marina Kugler
- Global Health Institute, University of Antwerp, Kinsbergen centrum, Doornstraat 331, 2610, Antwerp, Belgium
| | - An Hotterbeekx
- Global Health Institute, University of Antwerp, Kinsbergen centrum, Doornstraat 331, 2610, Antwerp, Belgium
| | - Adam Hendy
- Department of Pathology, University of Texas Medical Branch, Galveston, USA
| | | | - Robert Colebunders
- Global Health Institute, University of Antwerp, Kinsbergen centrum, Doornstraat 331, 2610, Antwerp, Belgium.
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Antivirus effectiveness of ivermectin on dengue virus type 2 in Aedes albopictus. PLoS Negl Trop Dis 2018; 12:e0006934. [PMID: 30452439 PMCID: PMC6277121 DOI: 10.1371/journal.pntd.0006934] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 12/03/2018] [Accepted: 10/18/2018] [Indexed: 12/27/2022] Open
Abstract
Background Dengue fever is the most rapidly spreading mosquito-borne viral disease over the past 50 years, with a 30-fold increase in global incidence. Dengue vector control is a key component for the dengue control strategy, since no absolutely effective vaccine or drug is available yet. However, the rapid rise and spread of mosquito insecticide resistance have become major threats to the efficiency of insecticide-based vector control activities. Thus, innovative vector control tools are badly needed. This study aims to confirm the antivirus effectiveness of ivermectin on dengue virus type 2 (DENV-2) in Aedes albopictus (Skuse, 1894), then to explore its potential use in the combating to the dengue epidemics. Methods Aedes albopictus were first infected with DENV-2 in human whole blood, and at the fourth day after infectious blood feeding, they were divided into eight groups. Seven of them were held for six days with access to 0, 2, 4, 8, 16, 32 and 64 ng/ml ivermectin, respectively, and the last one was set as a historical control group, which was stored at -80°C until being detected at the same time with the other groups. Each mosquito was detected using real-time fluorescent RT-PCR kit. DENV-2 RNA concentration (copies/ml) and infection rate in each group were compared. Results Both of quantitatively and qualitatively inhibiting effects of ivermectin have been detected in this study. Generally, DENV-2 replicated well in Aedes albopictus without ivermectin intervention, whose virus loads exhibited significantly higher when the mosquitoes were holding from 4 days to 10 days after infectious blood feeding. In contrast, with the treatment of ivermectin, the infection rate was reduced by as much as 49.63%. The regression equation between infection rates (Y2) and ivermectin concentration log2 values (X2) was obtained as Y2 = 91.41–7.21*X2 with R2 = 0.89. Conclusion Ivermectin can directly or indirectly inhibit DENV-2 multiplication in Aedes albopictus. Moreover, the actual concentration for application in zooprophylaxis needs to be confirmed in the further field trials. Dengue fever is one of neglected vector-borne tropical diseases with a 30-fold increase in global incidence recently. In 2012, World Health Organization set a goal to reduce dengue mortality by at least 50% by 2020. Being faced with more challenges in the dengue control programs, such as the increase of dengue outbreaks, lacking absolutely effective vaccine, rise of vector insecticide resistance and so on; innovative vector control tools are urgently needed for current control programs on dengue fever. To find a new avenue in vector control, we for the first time assessed the inhibiting effectiveness of ivermectin on dengue virus type 2 (DENV-2) inside Aedes mosquitoes. We found that about 80% Aedes albopictus mosquitoes were effectively infected with DENV-2 without treatment of ivermectin. But in the groups of ivermectin treatment, the infection rate of DENV-2 and the median of virus loads were significantly reduced by up to 49.63% and 99.99%, respectively. Both quantitatively and qualitatively inhibiting effects of ivermectin were detected. We found out that ivermectin was able to effectively inhibit the DENV-2 multiplication in Aedes albopictus, which may gave us a hint that using ivermectin in some control programs as a zooprophylaxis to block dengue epidemic through inhibiting DENV-2 in field Aedes mosquitoes.
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Abstract
The rapid spread of mosquito resistance to currently available insecticides, and the current lack of an efficacious malaria vaccine are among many challenges that affect large-scale efforts for malaria control. As goals of malaria elimination and eradication are put forth, new vector-control paradigms and tools and/or further optimization of current vector-control products are required to meet public health demands. Vector control remains the most effective measure to prevent malaria transmission and present gains against malaria mortality and morbidity may be maintained as long as vector-intervention strategies are sustained and adapted to underlying vector-related transmission dynamics. The following provides a brief overview of vector-control strategies and tools either in use or under development and evaluation that are intended to exploit key entomological parameters toward driving down transmission.
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Affiliation(s)
- Neil F Lobo
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana 46556
| | - Nicole L Achee
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana 46556
| | - John Greico
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana 46556
| | - Frank H Collins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana 46556
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Dadé M, Daniele M, Mestorino N. Evaluation of the toxic effects of doramectin, ivermectin and eprinomectin against Triatoma infestans using a rat model. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2017; 37:324-332. [PMID: 28968009 DOI: 10.7705/biomedica.v37i3.3316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 09/28/2016] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Pyrethroids have been frequently and intensively used for controlling the triatomine vectors of Trypanosoma cruzi. The emergence of resistance to these insecticides has resulted in an urgent need to identify novel, alternative and complementary control strategies. OBJECTIVE To evaluate the toxic effects of ivermectin, doramectin and eprinomectin on the bloodfeeding behaviour of Triatoma infestans using a rodent model. MATERIALS AND METHODS Fifth instar nymphs of T. infestans were fed at different times on Wistar rats pretreated with doramectin, ivermectin, eprinomectin or dimethylsulfoxide (excipient control) topically or orally administered. We determined the effects of each insecticide and of dimethyl sulfoxide on the amount of ingested blood, the volume of faecal discharge, and the mortality rates in triatomines. RESULTS Only the rate of triatomine mortality was associated with the antiparasitic compounds administered and the route of administration utilized. Doramectin administration was associated with a higher mortality rate (21.5%) than ivermectin, eprinomectin and dimethylsulfoxide (16, 11 and 2.5%, respectively), and topical administration was found to be most effective for inducing mortality (23 vs. 9.3 %). CONCLUSION These results demonstrate the toxic effects of the three assessed insecticides on T. infestans. The administration of ecto/endoparasiticides to domiciliary or peridomiciliary animals may serve as an interesting complementary strategy to the use of pyrethroids for the control of T. infestans.
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Affiliation(s)
- Martín Dadé
- Laboratorio de Estudios Farmacológicos y Toxicológicos, Cátedra de Farmacología, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina Cátedra de Farmacología Básica, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina.
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Tenywa FC, Kambagha A, Saddler A, Maia MF. The development of an ivermectin-based attractive toxic sugar bait (ATSB) to target Anopheles arabiensis. Malar J 2017; 16:338. [PMID: 28810866 PMCID: PMC5558776 DOI: 10.1186/s12936-017-1994-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/10/2017] [Indexed: 12/30/2022] Open
Abstract
Background An increasing number of countries in sub-Saharan Africa are moving towards malaria-elimination, mostly thanks to successful vector control campaigns. However, elimination has proven challenging, resulting in the persistence of malaria transmission. It is now accepted that in order to eliminate malaria, new complementary vector control approaches must be developed. This study describes the development of a sugar-baited resting place containing a toxic dose of ivermectin for the control of Anopheles arabiensis. Results Dose response experiments were performed in insectary conditions to determine the LD90 of ivermectin against An. arabiensis. Over 95% of An. arabiensis were knocked down 48 h post-sugar feeding on 10% sucrose solutions containing 0.01% ivermectin. When investigating different juices as attractants, it was observed that An. arabiensis preferred orange, watermelon and commercial guava juice over pawpaw, tomato, mango or banana, but were most likely to feed on simple 10% sugar solution. Using recycled materials, different bait prototypes were tested to determine the best design to maximize sugar feeding. Baits that offered a resting place for the mosquito rather than just a surface to sugar feed were more likely to attract An. arabiensis to sugar feed. The optimized prototype was then placed in different locations within a screen-house, colour-coded with different food dyes, containing competing vegetation (Ricinus communis) and experimental huts where humans slept under bed nets. Around half of all the released An. arabiensis sugar fed on the sugar baits, and approximately 50% of all sugar fed mosquitoes chose the baits close to outdoor vegetation before entering the huts. Conclusions Ivermectin is an effective insecticide for use in sugar baits. The design of the sugar bait can influence feeding rates and, therefore, efficacy. Sugar baits that offer a resting surface are more efficient and sugar feeding on the baits is maximized when these are placed close to peri-domestic vegetation. Attractive toxic sugar baited resting places may provide an additional vector control method to complement with existing strategies.
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Affiliation(s)
| | - Athumani Kambagha
- Ifakara Health Institute, P.O. Box 74, Bagamoyo, Pwani, United Republic of Tanzania
| | - Adam Saddler
- Ifakara Health Institute, P.O. Box 74, Bagamoyo, Pwani, United Republic of Tanzania.,Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland
| | - Marta Ferreira Maia
- Ifakara Health Institute, P.O. Box 74, Bagamoyo, Pwani, United Republic of Tanzania.,Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, St. Petersplatz 1, 4002, Basel, Switzerland.,Kemri Wellcome Trust Research Programme, CGMRC, PO Box 230-80108, Kilifi, Kenya
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Inhibition of Plasmodium Liver Infection by Ivermectin. Antimicrob Agents Chemother 2017; 61:AAC.02005-16. [PMID: 27895022 PMCID: PMC5278742 DOI: 10.1128/aac.02005-16] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 11/18/2016] [Indexed: 12/29/2022] Open
Abstract
Avermectins are powerful endectocides with an established potential to reduce the incidence of vector-borne diseases. Here, we show that several avermectins inhibit the hepatic stage of Plasmodium infection in vitro. Notably, ivermectin potently inhibits liver infection in vivo by impairing parasite development inside hepatocytes. This impairment has a clear impact on the ensuing blood stage parasitemia, reducing disease severity and enhancing host survival. Ivermectin has been proposed as a tool to control malaria transmission because of its effects on the mosquito vector. Our study extends the effect of ivermectin to the early stages of mammalian host infection and supports the inclusion of this multipurpose drug in malaria control strategies.
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Alout H, Foy BD. Ivermectin: a complimentary weapon against the spread of malaria? Expert Rev Anti Infect Ther 2016; 15:231-240. [PMID: 27960597 DOI: 10.1080/14787210.2017.1271713] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Ivermectin has transformed the treatment of parasitic diseases and led to incommensurable benefits to humans and animals. Ivermectin is effective in treating several neglected infectious diseases and recently it has been shown to reduce malaria parasite transmission. Areas covered: Malaria control strategies could benefit from the addition of ivermectin to interrupt the transmission cycle if it is a long lasting formulation or repeatedly administered. In turn, this will help also to control neglected infectious diseases where the elimination goal has been slower to achieve. Despite the relevance of using ivermectin for integrated and sustained disease control, there are still essential questions that remain to be addressed about safety and practicality. The efficacy in various malaria ecologies and the interaction between control tools, either drugs or insecticides, are also important to assess. Expert commentary: Overlapping distribution of several infectious diseases reveals the benefit of integrating control programs against several infectious diseases into one strategy for cost effectiveness and to reach the elimination goals. The use of ivermectin to control malaria transmission will necessitate development and testing of long-lasting formulations or repeated treatments, and implementation of these treatments with other disease control tools may increase the chance of successful and sustained control.
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Affiliation(s)
- Haoues Alout
- a Microbiology, Immunology and Pathology & Arthropod-borne Infectious Diseases Laboratory , Colorado State University , Fort Collins , CO , USA
| | - Brian D Foy
- a Microbiology, Immunology and Pathology & Arthropod-borne Infectious Diseases Laboratory , Colorado State University , Fort Collins , CO , USA
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Yakob L. Endectocide-treated cattle for malaria control: A coupled entomological-epidemiological model. Parasite Epidemiol Control 2016. [PMCID: PMC5991820 DOI: 10.1016/j.parepi.2015.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The malaria vector landscape is dynamic and dependence on indoor control tools has drastically affected both species compositions and local mosquito biting behaviours. In the advent of spreading behavioural resilience and physiological resistance to insecticidal nets and house spray, approaches to target more zoophilic, outdoor-biting vectors are being sought with increased urgency. Endectocides are insecticides applied to hosts which are taken up by the vectors during biting, and recent field assessments have demonstrated favourable results of cattle treated with ivermectin, diflubenzuron, eprinomectin and fipronil. Models were constructed to account for the modern, diverse vector feeding behaviours and assess their role in shaping malaria transmission and control with cattle-treated endectocides. Efficacy of this novel approach to malaria control is shown to be strongly dependent not only on intrinsic host preferences of the vector but also on how this preference is augmented by variation in the encounter rates with alternative blood-hosts. Ecological scenarios are presented whereby endectocides used on cattle yield equivalent, and in some cases improved, efficacy over nets and spray in controlling malaria transmission. Interactions between mosquito biting behaviours and relative availabilities of alternative blood-host species have largely been neglected in malaria programmatic strategy but will increasingly underlie sustaining the successes of vector control initiatives.
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Franco AO, Gomes MGM, Rowland M, Coleman PG, Davies CR. Controlling malaria using livestock-based interventions: a one health approach. PLoS One 2014; 9:e101699. [PMID: 25050703 PMCID: PMC4106824 DOI: 10.1371/journal.pone.0101699] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 06/10/2014] [Indexed: 11/18/2022] Open
Abstract
Where malaria is transmitted by zoophilic vectors, two types of malaria control strategies have been proposed based on animals: using livestock to divert vector biting from people (zooprophylaxis) or as baits to attract vectors to insecticide sources (insecticide-treated livestock). Opposing findings have been obtained on malaria zooprophylaxis, and despite the success of an insecticide-treated livestock trial in Pakistan, where malaria vectors are highly zoophilic, its effectiveness is yet to be formally tested in Africa where vectors are more anthropophilic. This study aims to clarify the different effects of livestock on malaria and to understand under what circumstances livestock-based interventions could play a role in malaria control programmes. This was explored by developing a mathematical model and combining it with data from Pakistan and Ethiopia. Consistent with previous work, a zooprophylactic effect of untreated livestock is predicted in two situations: if vector population density does not increase with livestock introduction, or if livestock numbers and availability to vectors are sufficiently high such that the increase in vector density is counteracted by the diversion of bites from humans to animals. Although, as expected, insecticide-treatment of livestock is predicted to be more beneficial in settings with highly zoophilic vectors, like South Asia, we find that the intervention could also considerably decrease malaria transmission in regions with more anthropophilic vectors, like Anopheles arabiensis in Africa, under specific circumstances: high treatment coverage of the livestock population, using a product with stronger or longer lasting insecticidal effect than in the Pakistan trial, and with small (ideally null) repellency effect, or if increasing the attractiveness of treated livestock to malaria vectors. The results suggest these are the most appropriate conditions for field testing insecticide-treated livestock in an Africa region with moderately zoophilic vectors, where this intervention could contribute to the integrated control of malaria and livestock diseases.
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Affiliation(s)
- Ana O. Franco
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Mark Rowland
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paul G. Coleman
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Clive R. Davies
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Chaccour CJ, Kobylinski KC, Bassat Q, Bousema T, Drakeley C, Alonso P, Foy BD. Ivermectin to reduce malaria transmission: a research agenda for a promising new tool for elimination. Malar J 2013; 12:153. [PMID: 23647969 PMCID: PMC3658945 DOI: 10.1186/1475-2875-12-153] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 05/01/2013] [Indexed: 11/11/2022] Open
Abstract
Background The heterogeneity of malaria transmission makes widespread elimination a difficult goal to achieve. Most of the current vector control measures insufficiently target outdoor transmission. Also, insecticide resistance threatens to diminish the efficacy of the most prevalent measures, indoor residual spray and insecticide treated nets. Innovative approaches are needed. The use of endectocides, such as ivermectin, could be an important new addition to the toolbox of anti-malarial measures. Ivermectin effectively targets outdoor transmission, has a novel mechanism of action that could circumvent resistance and might be distributed over the channels already in place for the control of onchocerciasis and lymphatic filariasis. Methods The previous works involving ivermectin and Anopheles vectors are reviewed and summarized. A review of ivermectin’s safety profile is also provided. Finally three definitive clinical trials are described in detail and proposed as the evidence needed for implementation. Several smaller and specific supportive studies are also proposed. Conclusions The use of ivermectin solves many challenges identified for future vector control strategies. It is an effective and safe endectocide that was approved for human use more than 25 years ago. Recent studies suggest it might become an effective and complementary strategy in malaria elimination and eradication efforts; however, intensive research will be needed to make this a reality.
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Affiliation(s)
- Carlos J Chaccour
- Internal Medicine Department, Clínica Universidad de Navarra, Av, Pio XII 36, Pamplona 31008, Spain.
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Kobylinski KC, Foy BD, Richardson JH. Ivermectin inhibits the sporogony of Plasmodium falciparum in Anopheles gambiae. Malar J 2012; 11:381. [PMID: 23171202 PMCID: PMC3519548 DOI: 10.1186/1475-2875-11-381] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 11/17/2012] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND When ingested in a blood meal, ivermectin has been shown to reduce the survivorship of Anopheles gambiae in the laboratory and field. Furthermore, ivermectin mass drug administrations in Senegal have been shown to reduce the proportion of Plasmodium falciparum-sporozoite-containing An. gambiae. This study addresses whether ivermectin inhibits sporogony of P. falciparum in An. gambiae. METHODS Anophele gambiae s.s. G3 strain were fed two concentrations of ivermectin (LC25 and LC5) along with P. falciparum NF54 in human blood meals at staggered intervals. Mosquitoes ingested ivermectin concurrent with parasites (DPI 0), or at three (DPI 3), six (DPI 6), and nine (DPI 9) days post parasite ingestion, or three days prior (DPI -3) to parasite ingestion. Mosquitoes were dissected at seven, twelve or fourteen days post parasite ingestion and either oocyst or sporozoite prevalence was recorded. To determine if P. falciparum sporozoite-containing An. gambiae were more susceptible to ivermectin than uninfected controls, survivorship was recorded for mosquitoes which ingested P. falciparum or control blood meal on DPI 0 and then a second blood meal containing ivermectin (LC25) on DPI 14. RESULTS Ivermectin (LC25) co-ingested (DPI 0) with parasites reduced the proportion of An. gambiae that developed oocysts (χ2 = 15.4842, P = 0.0002) and sporozoites (χ2 = 19.9643, P < 0.0001). Ivermectin (LC25) ingested DPI 6 (χ2 = 8.5103, P = 0.0044) and 9 (χ2 = 14.7998, P < 0.0001) reduced the proportion of An. gambiae that developed sporozoites but not when ingested DPI 3 (χ2 = 0.0113, P = 1). Ivermectin (LC5) co-ingested (DPI 0) with parasites did not reduce the proportion of An. gambiae that developed oocysts (χ2 = 4.2518, P = 0.0577) or sporozoites (χ2 = 2.3636, P = 0.1540), however, when ingested DPI -3 the proportion of An. gambiae that developed sporozoites was reduced (χ2 = 8.4806, P = 0.0047). Plasmodium falciparum infection significantly reduced the survivorship of An. gambiae that ingested ivermectin (LC25) on DPI 14 compared to control mosquitoes that ingested a primary blood meal without parasites (χ2 = 4.97, P = 0.0257). CONCLUSIONS Ivermectin at sub-lethal concentrations inhibits the sporogony of P. falciparum in An. gambiae. These findings support the utility of ivermectin for P. falciparum transmission control.
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Affiliation(s)
- Kevin C Kobylinski
- Entomology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA
| | - Brian D Foy
- Department of Microbiology, Immunology and Pathology, Arthropod-borne and Infectious Diseases Laboratory, Colorado State University, 1692 Campus Delivery, Fort Collins, CO, 80523-1692, USA
| | - Jason H Richardson
- Entomology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA
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Deus KM, Saavedra-Rodriguez K, Butters MP, Black WC, Foy BD. The effect of ivermectin in seven strains of Aedes aegypti (Diptera: Culicidae) including a genetically diverse laboratory strain and three permethrin resistant strains. JOURNAL OF MEDICAL ENTOMOLOGY 2012; 49:356-63. [PMID: 22493855 PMCID: PMC3942497 DOI: 10.1603/me11164] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Seven different strains of Aedes aegypti (L.), including a genetically diverse laboratory strain, three laboratory-selected permethrin-resistant strains, a standard reference strain, and two recently colonized strains were fed on human blood containing various concentrations of ivermectin. Ivermectin reduced adult survival, fecundity, and hatch rate of eggs laid by ivermectin-treated adults in all seven strains. The LC50 of ivermectin for adults and the concentration that prevented 50% of eggs from hatching was calculated for all strains. Considerable variation in adult survival after an ivermectin-bloodmeal occurred among strains, and all three permethrin-resistant strains were significantly less susceptible to ivermectin than the standard reference strain. The hatch rate after an ivermectin bloodmeal was less variable among strains, and only one of the permethrin-resistant strains differed significantly from the standard reference strain. Our studies suggest that ivermectin induces adult mortality and decreases the hatch rate of eggs through different mechanisms. A correlation analysis of log-transformed LC50 among strains suggests that permethrin and ivermectin cross-resistance may occur.
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Affiliation(s)
- K M Deus
- Colorado State University, Department of Microbiology, Immunology and Pathology, 1692 Campus Delivery, Fort Collins, CO 80523, USA.
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Foy BD, Kobylinski KC, da Silva IM, Rasgon JL, Sylla M. Endectocides for malaria control. Trends Parasitol 2011; 27:423-8. [PMID: 21727027 DOI: 10.1016/j.pt.2011.05.007] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 05/27/2011] [Accepted: 05/31/2011] [Indexed: 02/03/2023]
Abstract
Systemic endectocidal drugs, used to control nematodes in humans and other vertebrates, can be toxic to Anopheles spp. mosquitoes when they take a blood meal from a host that has recently received one of these drugs. Recent laboratory and field studies have highlighted the potential of ivermectin to control malaria parasite transmission if this drug is distributed strategically and more often. There are important theoretical benefits to this strategy, as well as caveats. A better understanding of drug effects against vectors and malaria ecologies are needed. In the near future, ivermectin and other endectocides could serve as potent and novel malaria transmission control tools that are directly linked to the control of neglected tropical diseases in the same communities.
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Affiliation(s)
- Brian D Foy
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523-1692, USA.
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Sylla M, Kobylinski KC, Gray M, Chapman PL, Sarr MD, Rasgon JL, Foy BD. Mass drug administration of ivermectin in south-eastern Senegal reduces the survivorship of wild-caught, blood fed malaria vectors. Malar J 2010; 9:365. [PMID: 21171970 PMCID: PMC3016374 DOI: 10.1186/1475-2875-9-365] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 12/20/2010] [Indexed: 11/25/2022] Open
Abstract
Background In south-eastern Senegal, malaria and onchocerciasis are co-endemic. Onchocerciasis in this region has been controlled by once or twice yearly mass drug administration (MDA) with ivermectin (IVM) for over fifteen years. Since laboratory-raised Anopheles gambiae s.s. are susceptible to ivermectin at concentrations found in human blood post-ingestion of IVM, it is plausible that a similar effect could be quantified in the field, and that IVM might have benefits as a malaria control tool. Methods In 2008 and 2009, wild-caught blood fed An. gambiae s.l. mosquitoes were collected from huts of three pairs of Senegalese villages before and after IVM MDAs. Mosquitoes were held in an insectary to assess their survival rate, subsequently identified to species, and their blood meals were identified. Differences in mosquito survival were statistically analysed using a Glimmix model. Lastly, changes in the daily probability of mosquito survivorship surrounding IVM MDAs were calculated, and these data were inserted into a previously developed, mosquito age-structured model of malaria transmission. Results Anopheles gambiae s.s. (P < 0.0001) and Anopheles arabiensis (P = 0.0191) from the treated villages had significantly reduced survival compared to those from control villages. Furthermore, An gambiae s.s. caught 1-6 days after MDA in treated villages had significantly reduced survival compared to control village collections (P = 0.0003), as well as those caught pre-MDA (P < 0.0001) and >7 days post-MDA (P < 0.0001). The daily probability of mosquito survival dropped >10% for the six days following MDA. The mosquito age-structured model of malaria transmission demonstrated that a single IVM MDA would reduce malaria transmission (Ro) below baseline for at least eleven days, and that repeated IVM MDAs would result in a sustained reduction in malaria Ro. Conclusions Ivermectin MDA significantly reduced the survivorship of An. gambiae s.s. for six days past the date of the MDA, which is sufficient to temporarily reduce malaria transmission. Repeated IVM MDAs could be a novel and integrative malaria control tool in areas with seasonal transmission, and which would have simultaneous impacts on neglected tropical diseases in the same villages.
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Affiliation(s)
- Massamba Sylla
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology & Pathology, Colorado State University, Fort Collins, Colorado, USA.
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Fritz ML, Siegert PY, Walker ED, Bayoh MN, Vulule JR, Miller JR. Toxicity of bloodmeals from ivermectin-treated cattle to Anopheles gambiae s.l. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2010; 103:539-47. [PMID: 19695159 DOI: 10.1179/000349809x12459740922138] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Two anthelmintic drugs used as cattle dewormers, ivermectin and moxidectin, were tested for their lethal and sublethal effects on the malarial vectors Anopheles gambiae s.s. and An. arabiensis. In the laboratory, direct addition of ivermectin to bovine blood reduced the survivorship and fecundity of mosquitoes fed on the blood. The median lethal concentration (LC(50)) of ivermectin in the bloodmeal, for the laboratory populations of An. gambiae s.l., was 19.8 ppb. In the field, commercially available formulations containing ivermectin or moxidectin were injected into cattle at three times the recommended dose. Most (90%) of the An. gambiae s.s. that fed on the ivermectin-treated cattle within 2 weeks of treatment failed to survive more than 10 days post-bloodmeal. No eggs were deposited by An. gambiae s.s. that fed on ivermectin-treated cattle within 10 days of treatment. In contrast, the survivorship and egg production of the mosquitoes that fed on the moxidectin-treated cattle were no different from those feeding on untreated cattle. These results indicate that treatment of cattle with ivermectin could be used, as part of an integrated control programme, to reduce the zoophilic vector populations that contribute to the transmission of the parasites responsible for human malaria.
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Affiliation(s)
- M L Fritz
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
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Munirathinam A, Sunish IP, Rajendran R, Tyagi BK. Impact of ivermectin drug combinations onPediculus humanus capitisinfestation in primary schoolchildren of south Indian rural villages. Int J Dermatol 2009; 48:1201-5. [DOI: 10.1111/j.1365-4632.2008.04059.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dembitsky VM. Astonishing diversity of natural surfactants: 2. Polyether glycosidic ionophores and macrocyclic glycosides. Lipids 2005; 40:219-48. [PMID: 15957249 DOI: 10.1007/s11745-005-1378-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Polyether glycosidic ionophores and macrocyclic glycosides are of great interest, especially for the medicinal and pharmaceutical industries. These biologically active natural surfactants are good prospects for the future chemical preparation of compounds useful as antibiotics, anticancer agents, or in industry. More than 300 interesting and unusual natural surfactants are described in this review article, including their chemical structures and biological activities.
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Affiliation(s)
- Valery M Dembitsky
- Department of Organic Chemistry and School of Pharmacy, Hebrew University, Jerusalem, Israel.
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Bockarie MJ, Alexander ND, Kazura JW, Bockarie F, Griffin L, Alpers MP. Treatment with ivermectin reduces the high prevalence of scabies in a village in Papua New Guinea. Acta Trop 2000; 75:127-30. [PMID: 10708015 DOI: 10.1016/s0001-706x(99)00087-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M J Bockarie
- Division of Geographic Medicine, Case Western Reserve University School of Medicine and University Hospital of Cleveland, OH 44106, USA.
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Bockarie MJ, Hii JL, Alexander ND, Bockarie F, Dagoro H, Kazura JW, Alpers MP. Mass treatment with ivermectin for filariasis control in Papua New Guinea: impact on mosquito survival. MEDICAL AND VETERINARY ENTOMOLOGY 1999; 13:120-123. [PMID: 10484157 DOI: 10.1046/j.1365-2915.1999.00159.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Field studies were carried out to determine the impact of mass human treatment with ivermectin on the survival of anthropophagic mosquitoes of the Anopheles punctulatus complex (Diptera: Culicidae), the vectors of lymphatic filariasis and malaria in Papua New Guinea. In a village where mass treatment had been given, using 400 microg/kg ivermectin plus 6 mg/kg diethylcarbamazine citrate (DEC), we performed pre- and post-treatment collections of freshly blood-engorged mosquitoes from the same nine bedrooms. All blood-fed mosquitoes collected less than 4 days after mass treatment died within 9 days, whereas 67% of those collected before treatment survived for >9 days. Comparison (using the log-rank test) of the survival curves for mosquitoes collected (i) before treatment, (ii)<4 days after treatment, and (iii) 28 days after treatment, showed the survival rate of group (ii) to be significantly lower than the other two (chi2=176, df=2, P<0.0001). Pre- and post-treatment all-night landing catches showed no reduction in human biting rates in the experimental village. In another village, where people were mass treated with ivermectin (400 microg/kg) only, the survival rates of freshly blood-engorged An. punctulatus collected from bedroom resting-sites less than 1 day after treatment, were compared to similar collections carried out at the same time in a nearby village where people were not treated with ivermectin. The 48-h survival rate for the ivermectin-treated village was 31% compared to 94% for the other; this difference was highly significant (chi2=32.42, df=1, P<0.0001). Mosquitoes fed 2 months post-treatment with DEC or collected 38 days post-treatment with ivermectin had normal survival rates. We conclude that the duration of the systemic lethal effect of ivermectin on mosquitoes is insufficient to be of epidemiological significance in filariasis control programmes that are based on biannual and annual single-dose treatments, but might reduce vectorial capacity sufficiently to block epidemics of dengue or even malaria.
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Affiliation(s)
- M J Bockarie
- Papua New Guinea Institute of Medical Research, Madang.
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Alexander ND, Bockarie MJ, Kastens WA, Kazura JW, Alpers MP. Absence of ivermectin-associated excess deaths. Trans R Soc Trop Med Hyg 1998; 92:342. [PMID: 9861413 DOI: 10.1016/s0035-9203(98)91035-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- N D Alexander
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
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Abstract
Efforts to control the spectrum of diseases that affect humans, our crops and our animals pose problems which need to be debated openly. Widespread use of chemicals in such a broad sphere raises important concerns not only about safety for the users, consumers and target species, but especially about the not so obvious effects upon the ecosystems in which they are used. Some undetermined level of biological diversity is necessary to maintain ecological function and resilience. These, in turn, are necessary for generating the biological resources (trees, fish, wildlife, crops) and ecological services (watershed protection, air cleansing, climate stabilisation, erosion control) on which economic activity and human welfare depend. The driving forces behind decline of biodiversity stem entirely from human activities. Underlying causes are those resulting from the cultural and social factors associated with economic activities and lead to direct depletion of species, and degradation or destruction of habitats. The broad spectrum and high efficacy of the macrocyclic lactones against nematode and arthropod parasites of livestock and companion animals are unprecedented. Cattle, horses, sheep, swine, dogs--to varying degrees all are utilised by humans for economic gain. Detrimental impact upon non-target animals is considered acceptable in eradicating parasites because of their economic importance to commercial livestock production. Production will increase when these parasites are eliminated, but we remain oblivious to the long-term consequences of our actions. What are the ecological limits to rural economic activities? Decomposing animal faeces help to maintain our ecosystem by returning valuable nutrients to the soil. Dung fauna-fungi, yeast, bacteria, nematodes, insects and earthworms--play a non-conspicuous but important and varied role in this decomposition process, a role dependent upon many factors, especially environmental ones. Anthelmintics and pesticides are of considerable value in agriculture, but largely at an unevaluated cost to the greater environment. We have insufficient knowledge of the extent to which a spectrum of anthelmintics and pesticides affect ecological function and ecosystem resilience in our commercial plant and animal production systems. It is time we developed a genuine interest in avoiding "the dialogue of the deal" that in the past has minimised interdisciplinary research between environmental ecology and commercial plant and animal production.
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Affiliation(s)
- D M Spratt
- CSIRO Division of Wildlife and Ecology, Lyneham, Australia.
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Abstract
Development in and transmission of hemoparasites by tick vectors are phenomena closely synchronized with the tick feeding cycle. In all known life cycles, initial infection of tick tissues occurs in midgut epithelial cells and transmission is effected as ticks feed after parasites have developed and multiplied in salivary glands. Many factors reviewed affect development and transmission of hemoparasites by ticks including age of ticks, artificial temperature, climate and/or season, tick stage or sex, hemoparasite variation, concurrent infection of ticks with other pathogens, host cell susceptibility, transovarial transmission, effect of hemoparasites on tick biology, and the effect of infecting parasitemia level in cattle on infection rates in ticks. Four hemoparasites of cattle, Anaplasma marginale, Cowdria ruminantium, Theileria parva, and Babesia spp., are all dependent on ticks for biological transmission. Babesia is transmitted transovarially whereas the other three are transmitted transstadially. Mechanical transfer of infective blood via fomites and mouthparts of biting arthropods is also a major means of transmission for Anaplasma marginale but not of the others. Potential control methods for hemoparasites that target parasites as they are developing in their respective tick hosts include tick control, vaccines (against ticks and parasites), and drugs (against ticks and parasites). Successful application of control strategies will be dependent upon thorough understanding of parasite developmental cycles, biology of the tick vectors and the immune response of cattle to ticks and to hemoparasites. The most effective control measures will be those that are targeted against both ticks and the hemoparasites they vector.
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Affiliation(s)
- K M Kocan
- Department of Veterinary Pathology, College of Veterinary Medicine, Oklahoma State University, Stillwater 74078, USA
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