首页 > 最新文献

Lancet Infectious Diseases最新文献

英文 中文
Correction to Lancet Infect Dis 2024; published online Oct 23. https://doi.org/10.1016/S1473-3099(24)00527-9
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-16 DOI: 10.1016/s1473-3099(25)00003-9
Macià D, Campo JJ, Jairoce C, et al. The effect of Plasmodium falciparum exposure and maternal anti-circumsporozoite protein antibodies on responses to RTS,S/AS01E vaccination in infants and children: an ancillary observational immunological study to a phase 3, randomised clinical trial. Lancet Infect Dis 2024; published online Oct 23. https://doi.org/10.1016/S1473-3099(24)00527-9—In the table of this Article, the † footnote has been removed from the Kintampo row of the Infant section. In figure 2, the correlation values in panel C have been coloured blue and purple to indicate the age group to which they are referring and the legend has been updated to state that, in panel B, “Green dots indicate significant results at a false discovery rate below 5%.” In panel A of figure 4, the text has been updated to refer to “High pre-vaccination Plasmodium falciparum IgG levels”. And in the Results section, the first sentence of the second paragraph has been corrected to “IgG levels to 981 (98%) out of 1000 P falciparum antigens showed a significant increase following a malaria episode”. These corrections have been made to the online version as of Jan 16, 2025, and will be made to the printed version.
{"title":"Correction to Lancet Infect Dis 2024; published online Oct 23. https://doi.org/10.1016/S1473-3099(24)00527-9","authors":"","doi":"10.1016/s1473-3099(25)00003-9","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00003-9","url":null,"abstract":"<em>Macià D, Campo JJ, Jairoce C, et al. The effect of</em> Plasmodium falciparum <em>exposure and maternal anti-circumsporozoite protein antibodies on responses to RTS,S/AS01</em><sub>E</sub> <em>vaccination in infants and children: an ancillary observational immunological study to a phase 3, randomised clinical trial.</em> Lancet Infect Dis <em>2024; published online Oct 23. https://doi.org/10.1016/S1473-3099(24)00527-9</em>—In the table of this Article, the † footnote has been removed from the Kintampo row of the Infant section. In figure 2, the correlation values in panel C have been coloured blue and purple to indicate the age group to which they are referring and the legend has been updated to state that, in panel B, “Green dots indicate significant results at a false discovery rate below 5%.” In panel A of figure 4, the text has been updated to refer to “High pre-vaccination <em>Plasmodium falciparum</em> IgG levels”. And in the Results section, the first sentence of the second paragraph has been corrected to “IgG levels to 981 (98%) out of 1000 <em>P falciparum</em> antigens showed a significant increase following a malaria episode”. These corrections have been made to the online version as of Jan 16, 2025, and will be made to the printed version.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"55 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expanding seasonal malaria chemoprevention beyond the Sahel region
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-15 DOI: 10.1016/s1473-3099(24)00766-7
Feiko O ter Kuile
No Abstract
{"title":"Expanding seasonal malaria chemoprevention beyond the Sahel region","authors":"Feiko O ter Kuile","doi":"10.1016/s1473-3099(24)00766-7","DOIUrl":"https://doi.org/10.1016/s1473-3099(24)00766-7","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"83 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of sulfadoxine–pyrimethamine plus amodiaquine and dihydroartemisinin–piperaquine for seasonal malaria chemoprevention in Uganda: a three-arm, open-label, non-inferiority and superiority, cluster-randomised, controlled trial
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-15 DOI: 10.1016/s1473-3099(24)00746-1
Anthony Nuwa, Kevin Baker, Richard Kajubi, Chukwudi A Nnaji, Katherine Theiss-Nyland, Musa Odongo, Tonny Kyagulanyi, Jane Nabakooza, David Salandini, Victor Asua, Maureen Nakirunda, Christian Rassi, Damian Rutazaana, Richard Achuma, Patrick Sagaki, John Baptist Bwanika, Godfrey Magumba, Adoke Yeka, Sam Nsobya, Moses R Kamya, Jimmy Opigo
<h3>Background</h3>Seasonal malaria chemoprevention (SMC) with sulfadoxine–pyrimethamine combined with amodiaquine (SPAQ) effectively protects eligible children from malaria in areas of high and seasonal transmission. However, concerns about parasite resistance to sulfadoxine–pyrimethamine in East and Southern Africa necessitate evaluating alternative drug regimens. This study assessed the effectiveness of SPAQ and dihydroartemisinin–piperaquine for SMC in Uganda.<h3>Methods</h3>This three-arm, open-label, non-inferiority and superiority, cluster-randomised, controlled trial was conducted in Karamoja subregion, Uganda, among children aged 3–59 months and 6–59 months for SPAQ and dihydroartemisinin–piperaquine, respectively. Of 427 villages, 380 were randomly assigned (1:1) to the SPAQ group and dihydroartemisinin–piperaquine group, and 47 were assigned to the control group (no SMC). The superiority component compared the SPAQ and dihydroartemisinin–piperaquine groups with the control group, whereas the non-inferiority component compared the dihydroartemisinin–piperaquine group with the SPAQ group. The primary endpoint was confirmed malaria incidence using rapid diagnostic tests or microscopy. Survival analyses were done on an intention-to-treat basis (in all randomised participants), with adjustments made for covariate imbalances at baseline. Additionally, molecular markers associated with resistance to sulfadoxine–pyrimethamine and amodiaquine were analysed on 750 malaria-positive blood samples from children younger than 5 years before and after five SMC cycles. This trial was registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT05323721</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, and has been completed.<h3>Findings</h3>During June 18–30, 2022, 3881 children were enrolled; 1755 in SPAQ, 1736 in dihydroartemisinin–piperaquine, and 390 in control villages. Of these children, 3629 were analysed. Incidence rates were 0·90 cases per 100 person-months in the SPAQ group, 0·80 cases per 100 person-months in the dihydroartemisinin–piperaquine group, and 18·26 cases per 100 person-months in the control group. SPAQ and dihydroartemisinin–piperaquine reduced malaria risk by 94% (hazard ratio [HR] 0·06 [95% CI 0·04–0·08]; p<0·001) and 96% (0·04 [0·03–0·06]; p<0·001), respectively. Based on the prespecified non-inferiority margin of 1·4, there was non-inferiority between the protective effectiveness of dihydroartemisinin–piperaquine and that of SPAQ (HR 0·90 [95% CI 0·58–1·39]). Prevalence of mutations linked to moderate (<em>Plasmodium falciparum</em> dihydrofolate red
{"title":"Effectiveness of sulfadoxine–pyrimethamine plus amodiaquine and dihydroartemisinin–piperaquine for seasonal malaria chemoprevention in Uganda: a three-arm, open-label, non-inferiority and superiority, cluster-randomised, controlled trial","authors":"Anthony Nuwa, Kevin Baker, Richard Kajubi, Chukwudi A Nnaji, Katherine Theiss-Nyland, Musa Odongo, Tonny Kyagulanyi, Jane Nabakooza, David Salandini, Victor Asua, Maureen Nakirunda, Christian Rassi, Damian Rutazaana, Richard Achuma, Patrick Sagaki, John Baptist Bwanika, Godfrey Magumba, Adoke Yeka, Sam Nsobya, Moses R Kamya, Jimmy Opigo","doi":"10.1016/s1473-3099(24)00746-1","DOIUrl":"https://doi.org/10.1016/s1473-3099(24)00746-1","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Seasonal malaria chemoprevention (SMC) with sulfadoxine–pyrimethamine combined with amodiaquine (SPAQ) effectively protects eligible children from malaria in areas of high and seasonal transmission. However, concerns about parasite resistance to sulfadoxine–pyrimethamine in East and Southern Africa necessitate evaluating alternative drug regimens. This study assessed the effectiveness of SPAQ and dihydroartemisinin–piperaquine for SMC in Uganda.&lt;h3&gt;Methods&lt;/h3&gt;This three-arm, open-label, non-inferiority and superiority, cluster-randomised, controlled trial was conducted in Karamoja subregion, Uganda, among children aged 3–59 months and 6–59 months for SPAQ and dihydroartemisinin–piperaquine, respectively. Of 427 villages, 380 were randomly assigned (1:1) to the SPAQ group and dihydroartemisinin–piperaquine group, and 47 were assigned to the control group (no SMC). The superiority component compared the SPAQ and dihydroartemisinin–piperaquine groups with the control group, whereas the non-inferiority component compared the dihydroartemisinin–piperaquine group with the SPAQ group. The primary endpoint was confirmed malaria incidence using rapid diagnostic tests or microscopy. Survival analyses were done on an intention-to-treat basis (in all randomised participants), with adjustments made for covariate imbalances at baseline. Additionally, molecular markers associated with resistance to sulfadoxine–pyrimethamine and amodiaquine were analysed on 750 malaria-positive blood samples from children younger than 5 years before and after five SMC cycles. This trial was registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT05323721&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, and has been completed.&lt;h3&gt;Findings&lt;/h3&gt;During June 18–30, 2022, 3881 children were enrolled; 1755 in SPAQ, 1736 in dihydroartemisinin–piperaquine, and 390 in control villages. Of these children, 3629 were analysed. Incidence rates were 0·90 cases per 100 person-months in the SPAQ group, 0·80 cases per 100 person-months in the dihydroartemisinin–piperaquine group, and 18·26 cases per 100 person-months in the control group. SPAQ and dihydroartemisinin–piperaquine reduced malaria risk by 94% (hazard ratio [HR] 0·06 [95% CI 0·04–0·08]; p&lt;0·001) and 96% (0·04 [0·03–0·06]; p&lt;0·001), respectively. Based on the prespecified non-inferiority margin of 1·4, there was non-inferiority between the protective effectiveness of dihydroartemisinin–piperaquine and that of SPAQ (HR 0·90 [95% CI 0·58–1·39]). Prevalence of mutations linked to moderate (&lt;em&gt;Plasmodium falciparum&lt;/em&gt; dihydrofolate red","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"9 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interim analysis of SARS-CoV-2 vaccine NVX-CoV2601 as a heterologous booster dose 作为异源加强剂量的 SARS-CoV-2 疫苗 NVX-CoV2601 的中期分析
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-14 DOI: 10.1016/s1473-3099(25)00005-2
Pragya D Yadav, Deepak Y Patil
No Abstract
{"title":"Interim analysis of SARS-CoV-2 vaccine NVX-CoV2601 as a heterologous booster dose","authors":"Pragya D Yadav, Deepak Y Patil","doi":"10.1016/s1473-3099(25)00005-2","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00005-2","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immunogenicity and safety of a monovalent omicron XBB.1.5 SARS-CoV-2 recombinant spike protein vaccine as a heterologous booster dose in US adults: interim analysis of a single-arm phase 2/3 study 单价奥米克XBB.1.5 SARS-CoV-2重组尖峰蛋白疫苗作为美国成人异源加强剂量的免疫原性和安全性:单臂2/3期研究中期分析
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-14 DOI: 10.1016/s1473-3099(24)00670-4
Katia Alves, Karen Kotloff, R Scott McClelland, Alex Kouassi, Joyce S Plested, Raj Kalkeri, MingZhu Zhu, Shane Cloney-Clark, Zhaohui Cai, Katherine Smith, Muneer Kaba, Joy Nelson, E Adrianne Hammershaimb, Raburn M Mallory, Fernando Noriega
<h3>Background</h3>Authorities globally recommended a monovalent omicron XBB.1.5-based COVID-19 vaccine for the 2023–24 season. The Novavax COVID-19 vaccine, NVX-CoV2601, contains XBB.1.5 recombinant spike protein, based on an authorised prototype vaccine (NVX-CoV2373) technology. We aimed to determine whether a single dose of NVX-CoV2601 versus NVX-CoV2373 (from a previous study [2019nCoV-311 part 2]) produced superior neutralising antibody (nAb) responses, and non-inferior seroresponse rates to XBB.1.5, after three or more previous mRNA-based COVID-19 vaccinations.<h3>Methods</h3>In part 1 of this single-arm, phase 2/3 study (2019nCoV-313), participants aged 18 years or older who had been previously vaccinated with three or more doses of mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) were enrolled across 30 US centres (research groups and universities) located across 20 states. Participants received one intramuscular injection of NVX-CoV2601 (5 μg XBB.1.5 spike plus 50 μg Matrix-M adjuvant). Coprimary endpoints were superiority of baseline-adjusted nAb geometric mean XBB.1.5 titres (adjusted GMTs), with superiority declared when the lower bound of the 95% CI for the GMT ratio (GMTR) was greater than 1, and non-inferiority of seroresponse rates, with non-inferiority declared when the lower bound of the 95% CI for the seroresponse rate difference was greater than –10%, on day 28; comparisons were made for NVX-CoV2601 administered in this study versus NVX-CoV2373 administered in part 2 (group G) of the 2019nCoV-311 study. Coprimary endpoints were assessed in the per-protocol immunogenicity set (ie, all participants who received study vaccine, underwent 28 days of follow-up, had day 0 and day 28 samples available, and had no major protocol deviations). Safety was a secondary endpoint and included assessments of solicited treatment-emergent adverse events up to 7 days and unsolicited treatment-emergent adverse events up to 28 days after vaccination in the safety analysis set (ie, all participants who received study vaccine). Here we report the prespecified interim analysis of immunogenicity and safety up to day 28. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT05975060</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, and is now complete.<h3>Findings</h3>Between Sept 7 and Sept 8, 2023, 380 individuals were screened, of whom 332 were enrolled and received study vaccine. At the 28-day interim analysis database lock (Jan 17, 2023), the per-protocol analysis sets included 309 (93%) of 332 NVX-CoV2601 recipients and 227 (90%) of 252 NVX-CoV2373 recipie
{"title":"Immunogenicity and safety of a monovalent omicron XBB.1.5 SARS-CoV-2 recombinant spike protein vaccine as a heterologous booster dose in US adults: interim analysis of a single-arm phase 2/3 study","authors":"Katia Alves, Karen Kotloff, R Scott McClelland, Alex Kouassi, Joyce S Plested, Raj Kalkeri, MingZhu Zhu, Shane Cloney-Clark, Zhaohui Cai, Katherine Smith, Muneer Kaba, Joy Nelson, E Adrianne Hammershaimb, Raburn M Mallory, Fernando Noriega","doi":"10.1016/s1473-3099(24)00670-4","DOIUrl":"https://doi.org/10.1016/s1473-3099(24)00670-4","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Authorities globally recommended a monovalent omicron XBB.1.5-based COVID-19 vaccine for the 2023–24 season. The Novavax COVID-19 vaccine, NVX-CoV2601, contains XBB.1.5 recombinant spike protein, based on an authorised prototype vaccine (NVX-CoV2373) technology. We aimed to determine whether a single dose of NVX-CoV2601 versus NVX-CoV2373 (from a previous study [2019nCoV-311 part 2]) produced superior neutralising antibody (nAb) responses, and non-inferior seroresponse rates to XBB.1.5, after three or more previous mRNA-based COVID-19 vaccinations.&lt;h3&gt;Methods&lt;/h3&gt;In part 1 of this single-arm, phase 2/3 study (2019nCoV-313), participants aged 18 years or older who had been previously vaccinated with three or more doses of mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) were enrolled across 30 US centres (research groups and universities) located across 20 states. Participants received one intramuscular injection of NVX-CoV2601 (5 μg XBB.1.5 spike plus 50 μg Matrix-M adjuvant). Coprimary endpoints were superiority of baseline-adjusted nAb geometric mean XBB.1.5 titres (adjusted GMTs), with superiority declared when the lower bound of the 95% CI for the GMT ratio (GMTR) was greater than 1, and non-inferiority of seroresponse rates, with non-inferiority declared when the lower bound of the 95% CI for the seroresponse rate difference was greater than –10%, on day 28; comparisons were made for NVX-CoV2601 administered in this study versus NVX-CoV2373 administered in part 2 (group G) of the 2019nCoV-311 study. Coprimary endpoints were assessed in the per-protocol immunogenicity set (ie, all participants who received study vaccine, underwent 28 days of follow-up, had day 0 and day 28 samples available, and had no major protocol deviations). Safety was a secondary endpoint and included assessments of solicited treatment-emergent adverse events up to 7 days and unsolicited treatment-emergent adverse events up to 28 days after vaccination in the safety analysis set (ie, all participants who received study vaccine). Here we report the prespecified interim analysis of immunogenicity and safety up to day 28. This study is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT05975060&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, and is now complete.&lt;h3&gt;Findings&lt;/h3&gt;Between Sept 7 and Sept 8, 2023, 380 individuals were screened, of whom 332 were enrolled and received study vaccine. At the 28-day interim analysis database lock (Jan 17, 2023), the per-protocol analysis sets included 309 (93%) of 332 NVX-CoV2601 recipients and 227 (90%) of 252 NVX-CoV2373 recipie","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"59 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantifying Plasmodium vivax radical cure efficacy: a modelling study integrating clinical trial data and transmission dynamics 量化间日疟原虫根治疗效:整合临床试验数据和传播动态的建模研究
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-13 DOI: 10.1016/s1473-3099(24)00689-3
Constanze Ciavarella, Chris Drakeley, Ric N Price, Ivo Mueller, Michael White

Background

Plasmodium vivax forms dormant liver stages (hypnozoites) that can reactivate weeks to months after primary infection. Radical cure requires a combination of antimalarial drugs to kill both the blood-stage and liver-stage parasites. Hypnozoiticidal efficacy of the liver-stage drugs primaquine and tafenoquine cannot be estimated directly because hypnozoites are undetectable. We aimed to estimate hypnozoiticidal efficacy from clinical trial data, and quantify the community-level impact of implementing case management with radical cure.

Methods

We calibrated a novel P vivax Recurrence Model to publicly available data from prospective clinical trials to estimate the hypnozoiticidal efficacy of different supervised primaquine (3·5 mg/kg or 7 mg/kg over 7 or 14 days) and tafenoquine (5 mg/kg or 7·5 mg/kg single dose) regimens in patients with normal glucose-6-phosphate dehydrogenase (G6PD) activity. We used an existing P vivax Individual-Based Model to quantify the 5-year impact of case management with unsupervised primaquine or tafenoquine regimens across various transmission settings.

Findings

We estimated median hypnozoiticidal efficacies of 99·1% (95% credible interval 96·0–100) for primaquine 7 mg/kg over 14 days; 96·3% (90·8–99·7) for primaquine 7 mg/kg over 7 days; 72·3% (68·1–76·3) for primaquine 3·5 mg/kg over 7 or 14 days; 62·4% (49·1–76·3) for tafenoquine 5 mg/kg single dose; and 87·5% (62·1–99·3) for tafenoquine 7·5 mg/kg single dose. 5 years of community-level tafenoquine case management was estimated to reduce P vivax transmission by 74–79% where pre-intervention prevalence as measured by PCR was low (<2%) and by 17–20% where prevalence as measured by PCR was high (around 35%). Similar 5-year reductions were estimated with primaquine case management only when adherence to the primaquine regimen was above 50%.

Interpretation

Substantial reductions in prevalence as measured by PCR were predicted with primaquine and tafenoquine regimens if these could be implemented with high coverage and adherence. The benefits of preventing P vivax relapses need to be balanced against the risks of inducing severe haemolysis in patients with G6PD deficiency.

Funding

Bill & Melinda Gates Foundation and Horizon Europe.
背景间日疟原虫(Plasmodium vivax)会在肝脏中形成休眠期寄生虫(hypnozoites),这些寄生虫会在原发性感染数周至数月后重新活化。根治需要联合使用多种抗疟药物,以杀死血期和肝期寄生虫。肝阶段药物伯氨喹和他非诺喹的杀亚寄生虫疗效无法直接估算,因为无法检测到亚寄生虫。我们的目标是根据临床试验数据估算低佐虫杀灭效果,并量化实施根治性病例管理对社区的影响。方法我们根据前瞻性临床试验的公开数据校准了新型间日疟复发模型,以估算在葡萄糖-6-磷酸脱氢酶(G6PD)活性正常的患者中,不同的伯氨喹(3-5 毫克/千克或 7 毫克/千克,7 天或 14 天)和他非诺喹(5 毫克/千克或 7-5 毫克/千克,单剂量)督导方案的降虫疗效。我们利用现有的基于个体的鼠疫模型,量化了在不同传播环境下使用无监督伯氨喹或他喹方案进行病例管理的 5 年影响。研究结果我们估计,伯氨喹 7 毫克/千克,14 天的中位杀虫效果为 99-1%(95% 可信区间为 96-0-100);伯氨喹 7 毫克/千克,7 天的中位杀虫效果为 96-3%(90-8-99-7);伯氨喹 3-5 毫克/千克,7 天或 14 天的中位杀虫效果为 72-3%(68-1-76-3);他芬喹 5 毫克/千克,单剂量的中位杀虫效果为 62-4%(49-1-76-3);他芬喹 7-5 毫克/千克,单剂量的中位杀虫效果为 87-5%(62-1-99-3)。据估计,如果干预前通过 PCR 测定的流行率较低(2%),5 年的社区级他芬喹病例管理可将间日疟原虫传播率降低 74-79%;如果通过 PCR 测定的流行率较高(约 35%),则可降低 17-20%。只有在伯氨喹治疗方案的依从性超过 50%时,伯氨喹病例管理的 5 年减少率估计与此相似。释义如果伯氨喹和他非诺喹治疗方案能够在高覆盖率和依从性的情况下实施,则根据 PCR 测量的流行率预计会大幅下降。预防间日疟复发的益处需要与诱发 G6PD 缺乏症患者严重溶血的风险相平衡。
{"title":"Quantifying Plasmodium vivax radical cure efficacy: a modelling study integrating clinical trial data and transmission dynamics","authors":"Constanze Ciavarella, Chris Drakeley, Ric N Price, Ivo Mueller, Michael White","doi":"10.1016/s1473-3099(24)00689-3","DOIUrl":"https://doi.org/10.1016/s1473-3099(24)00689-3","url":null,"abstract":"<h3>Background</h3><em>Plasmodium vivax</em> forms dormant liver stages (hypnozoites) that can reactivate weeks to months after primary infection. Radical cure requires a combination of antimalarial drugs to kill both the blood-stage and liver-stage parasites. Hypnozoiticidal efficacy of the liver-stage drugs primaquine and tafenoquine cannot be estimated directly because hypnozoites are undetectable. We aimed to estimate hypnozoiticidal efficacy from clinical trial data, and quantify the community-level impact of implementing case management with radical cure.<h3>Methods</h3>We calibrated a novel <em>P vivax</em> Recurrence Model to publicly available data from prospective clinical trials to estimate the hypnozoiticidal efficacy of different supervised primaquine (3·5 mg/kg or 7 mg/kg over 7 or 14 days) and tafenoquine (5 mg/kg or 7·5 mg/kg single dose) regimens in patients with normal glucose-6-phosphate dehydrogenase (G6PD) activity. We used an existing <em>P vivax</em> Individual-Based Model to quantify the 5-year impact of case management with unsupervised primaquine or tafenoquine regimens across various transmission settings.<h3>Findings</h3>We estimated median hypnozoiticidal efficacies of 99·1% (95% credible interval 96·0–100) for primaquine 7 mg/kg over 14 days; 96·3% (90·8–99·7) for primaquine 7 mg/kg over 7 days; 72·3% (68·1–76·3) for primaquine 3·5 mg/kg over 7 or 14 days; 62·4% (49·1–76·3) for tafenoquine 5 mg/kg single dose; and 87·5% (62·1–99·3) for tafenoquine 7·5 mg/kg single dose. 5 years of community-level tafenoquine case management was estimated to reduce <em>P vivax</em> transmission by 74–79% where pre-intervention prevalence as measured by PCR was low (&lt;2%) and by 17–20% where prevalence as measured by PCR was high (around 35%). Similar 5-year reductions were estimated with primaquine case management only when adherence to the primaquine regimen was above 50%.<h3>Interpretation</h3>Substantial reductions in prevalence as measured by PCR were predicted with primaquine and tafenoquine regimens if these could be implemented with high coverage and adherence. The benefits of preventing <em>P vivax</em> relapses need to be balanced against the risks of inducing severe haemolysis in patients with G6PD deficiency.<h3>Funding</h3>Bill &amp; Melinda Gates Foundation and Horizon Europe.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"75 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of 8-aminoquinolines for Plasmodium vivax malaria radical cure: only one part of the problem
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-13 DOI: 10.1016/s1473-3099(24)00771-0
Marcus Lacerda, Márcio Cortez
No Abstract
无摘要
{"title":"Efficacy of 8-aminoquinolines for Plasmodium vivax malaria radical cure: only one part of the problem","authors":"Marcus Lacerda, Márcio Cortez","doi":"10.1016/s1473-3099(24)00771-0","DOIUrl":"https://doi.org/10.1016/s1473-3099(24)00771-0","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"29 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treating a feverish planet: The Dengue Alliance
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-10 DOI: 10.1016/s1473-3099(25)00011-8
Vijay Shankar Balakrishnan
No Abstract
{"title":"Treating a feverish planet: The Dengue Alliance","authors":"Vijay Shankar Balakrishnan","doi":"10.1016/s1473-3099(25)00011-8","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00011-8","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"291 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Albendazole and ivermectin co-formulation for soil-transmitted helminthiases
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-10 DOI: 10.1016/s1473-3099(24)00720-5
Dora Buonfrate
No Abstract
{"title":"Albendazole and ivermectin co-formulation for soil-transmitted helminthiases","authors":"Dora Buonfrate","doi":"10.1016/s1473-3099(24)00720-5","DOIUrl":"https://doi.org/10.1016/s1473-3099(24)00720-5","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"21 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Albendazole–ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial
IF 56.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-10 DOI: 10.1016/s1473-3099(24)00669-8
Alejandro Krolewiecki, Stella Kepha, Pedro E Fleitas, Lisette van Lieshout, Woyneshet Gelaye, Augusto Messa, Javier Gandasegui, Jaime Algorta, Valdemiro Novela, Áuria de Jesus, Martin Rono, Dawit Degarege, Dereje Bedane, Jusper Mwahanje, Inácio Mandomando, Charles Mwandawiro, Wendemagegn Enbiale, José Muñoz
<h3>Background</h3>Treatments for soil-transmitted helminthiases face challenges, especially in addressing <em>Trichuris trichiura</em>. Combination regimens, particularly of ivermectin and albendazole, are promising. We aimed to assess the safety, efficacy, and palatability of a combination tablet for the treatment of <em>T trichiura</em>, hookworm, and <em>Strongyloides stercoralis</em> infections among school-aged children in Ethiopia, Kenya, and Mozambique.<h3>Methods</h3>We conducted an adaptive phase 2/3, randomised, parallel-group, active-controlled, superiority trial in 15 schools in Ethiopia, Kenya, and Mozambique. Eligible participants for both phases were aged 5–18 years, weighed at least 15 kg, and were infected with <em>T trichiura</em>, hookworms, or <em>S stercoralis</em>. Participants were randomly assigned via a computer-generated sequence to either a single dose of a fixed-dose combination (FDC×1) of albendazole (400 mg) plus ivermectin (9 mg or 18 mg), three consecutive daily doses of an FDC (FDC×3) of albendazole (400 mg) plus ivermectin (9 mg or 18 mg), or a single dose of albendazole alone (400 mg) via block randomisation, stratified by soil-transmitted helminth species. Participants and those administering the treatments were not masked to treatment assignment, but those assessing the outcomes were masked. The primary outcome of phase 2 (conducted in Kenya only) was safety during the first 3 h after the intervention and for 7 days, and the primary outcome of phase 3 was efficacy (ie, the proportion of individuals cured at day 21 out of the total number infected at baseline) for <em>T trichiura</em>; both primary outcomes were analysed in the intention-to-treat population. This trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT05124691</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, and is terminated.<h3>Findings</h3>Between Jan 20, 2022, and March 24, 2023, 1001 participants were recruited (465 [46%] were female and 536 [54%] were male). 636 (64%) were infected with <em>T trichiura</em>, 360 (36%) with hookworm, and 104 (10%) with <em>S stercoralis</em>; 94 (9%) of 1001 participants had co-infections and were included in the analysis of each infecting species. A total of 243 participants were allocated to the albendazole group, 381 to the FDC×1 group, and 377 to the FDC×3 group. In both phase 2 and 3, gastrointestinal symptoms were the most common mild-to-moderate adverse events in the FDC groups, but resolved within 48 h without intervention. At least one treatment-related adverse event occurred in 34 (14%) of 243 participants in t
{"title":"Albendazole–ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial","authors":"Alejandro Krolewiecki, Stella Kepha, Pedro E Fleitas, Lisette van Lieshout, Woyneshet Gelaye, Augusto Messa, Javier Gandasegui, Jaime Algorta, Valdemiro Novela, Áuria de Jesus, Martin Rono, Dawit Degarege, Dereje Bedane, Jusper Mwahanje, Inácio Mandomando, Charles Mwandawiro, Wendemagegn Enbiale, José Muñoz","doi":"10.1016/s1473-3099(24)00669-8","DOIUrl":"https://doi.org/10.1016/s1473-3099(24)00669-8","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Treatments for soil-transmitted helminthiases face challenges, especially in addressing &lt;em&gt;Trichuris trichiura&lt;/em&gt;. Combination regimens, particularly of ivermectin and albendazole, are promising. We aimed to assess the safety, efficacy, and palatability of a combination tablet for the treatment of &lt;em&gt;T trichiura&lt;/em&gt;, hookworm, and &lt;em&gt;Strongyloides stercoralis&lt;/em&gt; infections among school-aged children in Ethiopia, Kenya, and Mozambique.&lt;h3&gt;Methods&lt;/h3&gt;We conducted an adaptive phase 2/3, randomised, parallel-group, active-controlled, superiority trial in 15 schools in Ethiopia, Kenya, and Mozambique. Eligible participants for both phases were aged 5–18 years, weighed at least 15 kg, and were infected with &lt;em&gt;T trichiura&lt;/em&gt;, hookworms, or &lt;em&gt;S stercoralis&lt;/em&gt;. Participants were randomly assigned via a computer-generated sequence to either a single dose of a fixed-dose combination (FDC×1) of albendazole (400 mg) plus ivermectin (9 mg or 18 mg), three consecutive daily doses of an FDC (FDC×3) of albendazole (400 mg) plus ivermectin (9 mg or 18 mg), or a single dose of albendazole alone (400 mg) via block randomisation, stratified by soil-transmitted helminth species. Participants and those administering the treatments were not masked to treatment assignment, but those assessing the outcomes were masked. The primary outcome of phase 2 (conducted in Kenya only) was safety during the first 3 h after the intervention and for 7 days, and the primary outcome of phase 3 was efficacy (ie, the proportion of individuals cured at day 21 out of the total number infected at baseline) for &lt;em&gt;T trichiura&lt;/em&gt;; both primary outcomes were analysed in the intention-to-treat population. This trial is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT05124691&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, and is terminated.&lt;h3&gt;Findings&lt;/h3&gt;Between Jan 20, 2022, and March 24, 2023, 1001 participants were recruited (465 [46%] were female and 536 [54%] were male). 636 (64%) were infected with &lt;em&gt;T trichiura&lt;/em&gt;, 360 (36%) with hookworm, and 104 (10%) with &lt;em&gt;S stercoralis&lt;/em&gt;; 94 (9%) of 1001 participants had co-infections and were included in the analysis of each infecting species. A total of 243 participants were allocated to the albendazole group, 381 to the FDC×1 group, and 377 to the FDC×3 group. In both phase 2 and 3, gastrointestinal symptoms were the most common mild-to-moderate adverse events in the FDC groups, but resolved within 48 h without intervention. At least one treatment-related adverse event occurred in 34 (14%) of 243 participants in t","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"29 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Lancet Infectious Diseases
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1