The potential health impact of ivermectin mass drug administration for malaria control on swine in Mozambique

BACKGROUND: Both endo- and ectoparasites pose a great challenge to the health of pigs worldwide, placing a significant burden on low-resource countries where veterinary care is minimal. As part of a larger clinical trial assessing the use of ivermectin (IVM) mass drug administration to humans and pigs for the control of malaria vectors in the Mopeia district in Mozambique, a longitudinal study to assess the impact of IVM administration on pig health was performed. METHODS: Beginning in March 2022, IVM was administered to pigs in the intervention area once a month for three consecutive months. Seventy pigs from the treatment group and 70 pigs from the control group were randomly selected for inclusion in the study. Fecal samples were collected monthly for three months and analyzed for the presence of strongyle eggs, strongyle eggs in the larval stage (strongyles – larval) and Ascaris suum using the modified McMaster test. Fecal samples were also collected two weeks after each dose of IVM was given to pigs in the treatment group for determination of a fecal egg reduction count. Juvenile pigs were measured twice a month for the first 3 months of the study, then once monthly for another three months. Visual exam for ectoparasites was performed on all pigs for the presence of ticks, lice or scabies at the same time points.
RESULTS: Overall, 55% [95% CI: 48-62%] of pigs were positive for Ascaris suum, 95.2% [95% CI: 91-98%] were positive for strongyle eggs, and 72.5% [95% CI: 65.5-79%] were positive for strongyle – larval. A significant difference in the ivermectin treatment group was only seen one month after the second dose of ivermectin was administered: pigs in the treatment group had a 23.6% lower prevalence of strongyles (p = 0.003) and 18% lower prevalence of strongyles – larval (p = 0.03). Pigs in the treatment group also had lower EPG for Ascaris suum (diff = 102 EPG; p = 0.006), strongyles (diff = 642 EPG; p < 0.001), and strongyles - larval (diff = 217 EPG; p < 0.001). Analysis of covariance regression found no significant difference(P>0.05) in average daily weight gain (ADG) between the treatment and control groups. CONCLUSION: IVM delivered once monthly for three months has a small impact on pig health. To counteract the multiple health challenges pigs face in these settings, different dosing schedules along with education on husbandry issues related to nutrition and sanitation should be investigated in order to maximize impact on pig health.