A clinical trial presented at ASTMH 2025 in Toronto shows ivermectin can be safely given to very young children weighing as little as 5 kilograms, widening eligibility for mass drug administration against neglected tropical diseases.

The study aims to reassure regulators and manufacturers about safety of ivermectin in children under 15 kilograms, addressing prior safety gaps and potentially expanding MDA campaigns.

Beyond treatment, linking early ivermectin use with nutrition programs and malaria vector control could improve overall health outcomes in endemic regions.

Expanding use to smaller children could improve outcomes for intestinal helminth infections by addressing malnutrition, stunting, and cognitive impairment linked to chronic infection.

Reducing treatment exclusions may enhance malaria control, as ivermectin can lower transmission by affecting Anopheles mosquitoes, especially with broad MDA coverage around 70%.

Building on a prior systematic review and meta-analysis, the trial seeks to support broader inclusion of smaller children in MDA to reduce disease burden and transmission.

Removing weight-based barriers could accelerate control of onchocerciasis by enabling earlier intervention and potentially reducing immune-mediated neurological complications.

Endorsements from the American Society of Tropical Medicine and Hygiene and its leadership lend weight to the study’s implications for science and global health policy.

Broader eligibility could reach more children, supporting mass drug administration and accelerating control of multiple neglected tropical diseases.

Lead author Kevin Kobylinski notes that including small children in MDA could substantially reduce disease burden, with potential to influence malaria transmission when coverage nears 70%.

Widening age/weight eligibility could reduce scabies transmission, given the high disease burden among children and close-contact dynamics.

The trial used robust methods—double-blind randomization and multi-site monitoring—conducted with Mahidol Oxford Tropical Medicine Research Unit to support generalizability.