Protocol for a cluster randomised placebo-controlled trial of adjunctive ivermectin mass drug administration for malaria control on the Bijagós Archipelago of Guinea-Bissau: the MATAMAL trial

A groundbreaking trial on the Bijagós Archipelago, Guinea-Bissau, investigates whether combining ivermectin with artemisinin-based combination therapy (ACT) can significantly enhance malaria control and transmission reduction. The MATAMAL trial, a cluster-randomized placebo-controlled study, aims to determine if adjunctive ivermectin mass drug administration (MDA) surpasses ACT alone in lowering Plasmodium falciparum parasitaemia prevalence during peak transmission seasons. By leveraging ivermectin's dual role—reducing vector survival while treating co-endemic diseases—the trial seeks to address challenges posed by ACT resistance and limited intervention coverage. With 24 clusters receiving either combined or placebo MDA, the study meticulously evaluates outcomes over two years, including malaria incidence, vector dynamics, and resistance markers. Ethical approvals from both UK and Guinea-Bissau ensure rigorous adherence to standards, while findings will inform global malaria elimination strategies.

Hutchins, H., Bradley, J., Pretorius, E., Teixeira da Silva, E., Vasileva, H., Jones, R. T., Ndiath, M. O., dit Massire Soumare, H., Mabey, D., Nante, E. J., Martins, C., Logan, J. G., Slater, H., Drakeley, C., D’Alessandro, U., Rodrigues, A., & Last, A. R. (2023). Protocol for a cluster randomised placebo-controlled trial of adjunctive ivermectin mass drug administration for malaria control on the Bijagós Archipelago of Guinea-Bissau: the MATAMAL trial. BMJ Open, 13(7), e072347. https://doi.org/10.1136/bmjopen-2023-072347