Department of Microbiology, Immunology & Pathology, Colorado State University, Fort Collins, CO 80523-1692, USA.
Acta Trop. 2010 Nov;116(2):119-26. doi: 10.1016/j.actatropica.2010.06.001. Epub 2010 Jun 9.
In the Tropics, there is substantial temporal and spatial overlap of diseases propagated by anthropophilic mosquito vectors (such as malaria and dengue) and human helminth diseases (such as onchocerciasis and lymphatic filariasis) that are treated though mass drug administrations (MDA). This overlap will result in mosquito vectors imbibing significant quantities of these drugs when they blood feed on humans. Since many anthelmintic drugs have broad anti-invertebrate effects, the possibility of combined helminth control and mosquito-borne disease control through MDA is apparent. It has been previously shown that ivermectin can reduce mosquito survivorship when administered in a blood meal, but more detailed examinations are needed if MDA is to ever be developed into a tool for malaria or dengue control. We examined concentrations of drugs that follow human pharmacokinetics after MDA and that matched with mosquito feeding times, for effects against the anthropophilic mosquito vectors Anopheles gambiae s.s. and Aedes aegypti. Ivermectin was the only human-approved MDA drug we tested that affected mosquito survivorship, and only An. gambiae s.s. were affected at concentrations respecting human pharmacokinetics at indicated doses. Ivermectin also delayed An. gambiae s.s. re-feeding frequency and defecation rates, and two successive ivermectin-spiked blood meals following human pharmacokinetic concentrations compounded mortality effects compared to controls. These findings suggest that ivermectin MDA in Africa may be used to decrease malaria transmission if MDAs were administered more frequently. Such a strategy would broaden the current scope of polyparasitism control already afforded by MDAs, and which is needed in many African villages simultaneously burdened by many parasitic diseases.
在热带地区，由嗜人血蚊子传播的疾病（如疟疾和登革热）与通过大规模药物治疗（MDA）治疗的人类寄生虫病（如盘尾丝虫病和淋巴丝虫病）在时间和空间上有很大的重叠。这种重叠将导致蚊子在吸食人类血液时摄入大量这些药物。由于许多驱虫药对无脊椎动物有广泛的抗作用，因此通过 MDA 进行寄生虫病和蚊媒病联合控制的可能性是明显的。先前已经表明，在给予血餐时，伊维菌素可以降低蚊子的存活率，但如果 MDA 要发展成为疟疾或登革热控制的工具，还需要更详细的检查。我们检查了 MDA 后遵循人体药代动力学并与蚊子取食时间匹配的药物浓度，以评估其对嗜人血蚊子媒介冈比亚按蚊和埃及伊蚊的作用。我们测试的唯一一种人类批准的 MDA 药物伊维菌素影响了蚊子的存活率，只有按蚊受到影响，而且在指示剂量下，浓度符合人体药代动力学。伊维菌素还延迟了冈比亚按蚊再次取食的频率和排粪率，并且在两次连续的伊维菌素加药血餐后，与对照相比，死亡率效应加剧。这些发现表明，如果 MDA 更频繁地进行，非洲的 MDA 伊维菌素可能用于减少疟疾传播。这种策略将扩大 MDA 目前已经提供的多寄生虫病控制范围，而在许多同时受到多种寄生虫病困扰的非洲村庄中，这种策略是非常必要的。
