Impact of ivermectin components on Anopheles dirus and Anopheles minimus mosquito survival.

Background: Ivermectin mass drug administration to humans or livestock is a potential vector control tool for malaria elimination. Racemic ivermectin is composed of two components, namely a major component (> 80%; ivermectin B), which has an ethyl group at C-26, and a minor component (< 20%; ivermectin B), which has a methyl group at C-26. There is no difference between the efficacy of ivermectin B and ivermectin B efficacy in nematodes, but only ivermectin B has been reported to be lethal to snails. The ratios of ivermectin B and B ratios in ivermectin formulations and tablets can vary between manufacturers and batches. The mosquito-lethal effects of ivermectin B and ivermectin B have never been assessed. As novel ivermectin formulations are being developed for malaria control, it is important that the mosquito-lethal effects of individual ivermectin B and ivermectin B compounds be evaluated.

Methods: Racemic ivermectin, ivermectin B or ivermectin B, respectively, was mixed with human blood at various concentrations, blood-fed to Anopheles dirus sensu stricto and Anopheles minimus sensu stricto mosquitoes, and mortality was observed for 10 days. The ivermectin B and B ratios from commercially available racemic ivermectin and marketed tablets were assessed by liquid chromatography-mass spectrometry.

Results: The results revealed that neither the lethal concentrations that kills 50% (LC) nor 90% (LC) of mosquitoes differed between racemic ivermectin, ivermectin B or ivermectin B for An. dirus or An. minimus, confirming that the individual ivermectin components have equal mosquito-lethal effects. The relative ratios of ivermectin B and B derived from sourced racemic ivermectin powder were 98.84% and 1.16%, respectively, and the relative ratios for ivermectin B and B derived from human oral ivermectin tablets were 98.55% and 1.45%, respectively.

Conclusions: The ratio of ivermectin B and B does not influence the Anopheles mosquito-lethal outcome, an ideal study result as the separation of ivermectin B and B components at scale is cost prohibitive. Thus, variations in the ratio of ivermectin B and B between batches and manufacturers, as well as potentially novel formulations for malaria control, should not influence ivermectin mosquito-lethal efficacy.