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Thị Trấn Thanh Lưu, Vietnam

Rueangweerayut R.,Mae Sot General Hospital | Phyo A.P.,Shoklo Malaria Research Unit | Uthaisin C.,Mae Ramat Hospital | Poravuth Y.,National Malaria Center | And 10 more authors.
New England Journal of Medicine | Year: 2012

BACKGROUND: Pyronaridine-artesunate is an artemisinin-based combination therapy under evaluation for the treatment of Plasmodium falciparum and P. vivax malaria. METHODS: We conducted a phase 3, open-label, multicenter, noninferiority trial that included 1271 patients between 3 and 60 years of age from Asia (81.3%) or Africa (18.7%) with microscopically confirmed, uncomplicated P. falciparum malaria. Patients underwent randomization for treatment with a fixed-dose combination of 180 mg of pyronaridine and 60 mg of artesunate or with 250 mg of mefloquine plus 100 mg of artesunate. Doses were calculated according to body weight and administered once daily for 3 days. RESULTS: Pyronaridine-artesunate was noninferior to mefloquine plus artesunate for the primary outcome: adequate clinical and parasitologic response in the per-protocol population on day 28, corrected for reinfection with the use of polymerase-chain-reaction (PCR) genotyping. For this outcome, efficacy in the group receiving pyronaridine-artesunate was 99.2% (743 of 749 patients; 95% confidence interval [CI], 98.3 to 99.7) and that in the group receiving mefloquine plus artesunate was 97.8% (360 of 368 patients; 95% CI, 95.8 to 99.1), with a treatment difference of 1.4 percentage points (95% CI, 0.0 to 3.5; P = 0.05). In the intention-to-treat population, efficacy on day 42 in the group receiving pyronaridine-artesunate was 83.1% (705 of 848 patients; 95% CI, 80.4 to 85.6) and that in the group receiving mefloquine plus artesunate was 83.9% (355 of 423 patients; 95% CI, 80.1 to 87.3). In Cambodia, where there were 211 study patients, the median parasite clearance time was prolonged for both treatments: 64 hours versus 16.0 to 38.9 hours in other countries (P<0.001, on the basis of Kaplan-Meier estimates). Kaplan-Meier estimates of the recrudescence rate in the intention-to-treat population in Cambodia until day 42 were higher with pyronaridine-artesunate than with mefloquine plus artesunate (10.2% [95% CI, 5.4 to 18.6] vs. 0%; P = 0.04 as calculated with the log-rank test), but similar for the other countries combined (4.7% [95% CI, 3.3 to 6.7] and 2.8% [95% CI, 1.5 to 5.3], respectively; P = 0.24). Elevated levels of aminotransferases were observed in those receiving pyronaridine-artesunate. Two patients receiving mefloquine plus artesunate had seizures. CONCLUSIONS: Fixed-dose pyronaridine-artesunate was efficacious in the treatment of uncomplicated P. falciparum malaria. In Cambodia, extended parasite clearance times were suggestive of in vivo resistance to artemisinin. (Funded by Shin Poong Pharmaceutical Company and the Medicines for Malaria Venture; ClinicalTrials.gov number, NCT00403260.) Copyright © 2012 Massachusetts Medical Society. Source


Clausen J.H.,Copenhagen University | Madsen H.,Copenhagen University | Murrell K.D.,Copenhagen University | Van P.T.,Research Institute For Aquaculture No1 | And 5 more authors.
Emerging Infectious Diseases | Year: 2012

Worldwide, >18 million persons were infected with fish-borne zoonotic trematodes in 2002. To evaluate the effectiveness of interventions for reducing prevalence and intensity of fish-borne zoonotic trematode infections in juvenile fish, we compared transmission rates at nurseries in the Red River Delta, northern Vietnam. Rates were significantly lower for nurseries that reduced snail populations and trematode egg contamination in ponds than for nurseries that did not. These interventions can be used in the development of programs for sustained control of zoonotic trematodes in farmed fish. Source


Dujardin J.-P.,Institute Of Recherches Pour Le Developpement | Lam T.X.,Vietnam Academy of Science and Technology | Khoa P.T.,National Institute of Malariology | Schofield C.J.,London School of Hygiene and Tropical Medicine
Memorias do Instituto Oswaldo Cruz | Year: 2015

The migration of invasive vector species has contributed to the worldwide extension of infectious diseases such as dengue (Aedes aegypti) and chikungunya (Aedes albopictus). It is probably a similar behaviour for certain vectors of Chagas disease which allowed it to become a continental burden in Latin America. One of them, Triatoma rubrofasciata has also been spreading throughout the tropical and subtropical world. Here, the recent and massive peridomestic presence of T. rubrofasciata in Vietnam cities is reported, and tentatively explained, highlighting the need for improved entomological surveillance. © 2015, Fundacao Oswaldo Cruz. All rights reserved. Source


Durnez L.,Institute of Tropical Medicine | Van Bortel W.,Institute of Tropical Medicine | Denis L.,Institute of Tropical Medicine | Roelants P.,Institute of Tropical Medicine | And 4 more authors.
Malaria Journal | Year: 2011

Background: The entomological inoculation rate (EIR) is an important indicator in estimating malaria transmission and the impact of vector control. To assess the EIR, the enzyme-linked immunosorbent assay (ELISA) to detect the circumsporozoite protein (CSP) is increasingly used. However, several studies have reported false positive results in this ELISA. The false positive results could lead to an overestimation of the EIR. The aim of present study was to estimate the level of false positivity among different anopheline species in Cambodia and Vietnam and to check for the presence of other parasites that might interact with the anti-CSP monoclonal antibodies. Methods. Mosquitoes collected in Cambodia and Vietnam were identified and tested for the presence of sporozoites in head and thorax by using CSP-ELISA. ELISA positive samples were confirmed by a Plasmodium specific PCR. False positive mosquitoes were checked by PCR for the presence of parasites belonging to the Haemosporidia, Trypanosomatidae, Piroplasmida, and Haemogregarines. The heat-stability and the presence of the cross-reacting antigen in the abdomen of the mosquitoes were also checked. Results: Specimens (N = 16,160) of seven anopheline species were tested by CSP-ELISA for Plasmodium falciparum and Plasmodium vivax (Pv210 and Pv247). Two new vector species were identified for the region: Anopheles pampanai (P. vivax) and Anopheles barbirostris (Plasmodium malariae). In 88% (155/176) of the mosquitoes found positive with the P. falciparum CSP-ELISA, the presence of Plasmodium sporozoites could not be confirmed by PCR. This percentage was much lower (28% or 5/18) for P. vivax CSP-ELISAs. False positive CSP-ELISA results were associated with zoophilic mosquito species. None of the targeted parasites could be detected in these CSP-ELISA false positive mosquitoes. The ELISA reacting antigen of P. falciparum was heat-stable in CSP-ELISA true positive specimens, but not in the false positives. The heat-unstable cross-reacting antigen is mainly present in head and thorax and almost absent in the abdomens (4 out of 147) of the false positive specimens. Conclusion: The CSP-ELISA can considerably overestimate the EIR, particularly for P. falciparum and for zoophilic species. The heat-unstable cross-reacting antigen in false positives remains unknown. Therefore it is highly recommended to confirm all positive CSP-ELISA results, either by re-analysing the heated ELISA lysate (100°C, 10 min), or by performing Plasmodium specific PCR followed if possible by sequencing of the amplicons for Plasmodium species determination. © 2011 Durnez et al; licensee BioMed Central Ltd. Source


Phan V.T.,University of Southern Denmark | Ersboll A.K.,University of Southern Denmark | Do D.T.,National Institute of Malariology | Dalsgaard A.,Copenhagen University
Foodborne Pathogens and Disease | Year: 2011

Raw fish consumption in restaurants, for example, Sashimi style, is popular worldwide. In Vietnam, raw fish dishes are also traditionally prepared and consumed in private households. However, the habits of eating raw or otherwise inadequately cooked fish can be associated with risks of acquiring fishborne zoonotic trematode (FZT) infection. The present study was done in a fish-farming community in Nam Dinh, Vietnam, to obtain information about habits of eating raw fish dishes and risks for human FZT infection. Discussions were held in different groups divided by gender and age on raw-fish-eating behavior. A total of 180 household members were interviewed and their stool samples analyzed to identify risk factors of FZT infection. There was awareness about the risk of liver fluke infections from eating raw fish. However, many older people accepted these risks and continued eating raw fish, as they know effective drug treatment is available. Raw fish dishes are consumed at social gatherings from shared plates and dipping sauces using the same chop sticks. This is likely to pose risks of crosscontamination with FZT metacercariae to different food items as indicated by the finding that 25.8% of household members that stated not to have eaten raw fish were infected. In total, 32.2% fish farm household members were infected with FZT. The odds of FZT infection was 2.3 times higher (p=0.013) for those eating raw fish than for those who did not eat raw fish. Among the people eating raw fish, those eating raw fish in restaurants had 3.6 times higher odds of FZT infection (p=0.009) than people eating raw fish at home. A successful program to control FZT must be based on in-depth knowledge on the social and anthropological determinants of people's raw-fish-eating behavior and hygiene practices as well as production of FZT-free fish for human consumption. © Copyright 2011, Mary Ann Liebert, Inc. 2011. Source

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