Safety and efficacy of three alternative regimens against relapsing Plasmodium vivax malaria in glucose 6-phosphate dehydrogenase deficient patients in the Brazilian Amazon (ALTPRIM).

Background: Daily primaquine-induced hemolysis is a common cause of complications during Plasmodium vivax malaria treatment in individuals with glucose 6-phosphate dehydrogenase deficiency (G6PDd). Alternative regimens balancing safety and efficacy are needed.

Methods: G6PDd participants with P.

Relative efficacy of anti-Plasmodium vivax malaria combination drugs in preventing transmission to two major Anopheles mosquitoes in the first few days of treatment.

Objectives: The World Health Organization recommends three drug anti-malarial combinations: cloroquine+primaquine, artesiminin+primaquine, and cloroquine+tafenoquine. These combinations aim to eradicate Plasmodium by disrupting its life cycle within the human body. We evaluated the effect of these medications on the vectorial competence of two main vectors in the New World.

Association of and Genetic Variants on Primaquine Hemolysis in G6PD-Deficient Patients.

In the Amazon, the treatment for is chloroquine plus primaquine. However, this regimen is limited due to the risk of acute hemolytic anemia in glucose-6-phosphate dehydrogenase deficiency. Primaquine is a prodrug that requires conversion by the CYP2D6 enzyme to be effective against malaria.

Quantitative G6PD Deficiency Screening in Routine Malaria Diagnostic Units in the Brazilian Amazon (SAFEPRIM): An Operational Mixed-Methods Study.

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency testing is not routinely performed before primaquine treatment in most endemic areas, despite the risk of primaquine-associated hemolysis. This is due to the operational challenges associated with pragmatic G6PD testing and as such needs to be addressed.

Methods And Findings: This mixed-methods operational study was aimed at implementing the quantitative point-of-care Standard G6PD (SD Biosensor, Korea) screening test in malaria treatment units (MTUs) in the municipalities of Rio Preto da Eva and Mâncio Lima, in the Brazilian Amazon, between mid-January 2020 and December 2020.

System Management Software for Emergency Call.

Unlabelled: Present the experience of the development of a system as an effective communication strategy between the user/requester and the mobile prehospital care service.

Approach: It is a methodological study, fragmented into five stages, developed by health and technology professionals and students.

Result: The five stages were followed to reach the final product.

Real-life implementation of a G6PD deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian Amazon (SAFEPRIM study).

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency greatly hinders Plasmodium vivax malaria radical cure and further elimination due to 8-aminoquinolines-associated hemolysis. Although the deleterious health effects of primaquine in G6PD deficient individuals have been known for over 50 years, G6PD testing is not routinely performed before primaquine treatment in most P. vivax endemic areas.

An Ultra-Sensitive Technique: Using -mtCOX1 qPCR to Detect Early Recurrences of in Patients in the Brazilian Amazon.

Background: Early recurrence of is a challenge for malaria control in the field, particularly because this species is associated with lower parasitemia, which hinders diagnosis and monitoring through blood smear testing. Early recurrences, defined as the persistence of parasites in the peripheral blood despite adequate drug dosages, may arise from resistance to chloroquine. The objective of the study was to estimate early recurrence of in the Brazilian Amazon by using a highly-sensitive detection method, in this case, PCR.

Influence of , , and Host Genotypes on Early Recurrence of Plasmodium vivax.

Cytochrome P450 (CYP) enzymes are involved in the biotransformation of chloroquine (CQ), but the role of the different profiles of metabolism of this drug in relation to recurrences has not been properly investigated. To investigate the influence of the CYP genotypes associated with CQ metabolism on the rates of early recurrences, a case-control study was carried out. The cases included patients presenting with an early recurrence (CQ-recurrent individuals), defined as a recurrence during the first 28 days after initial infection and plasma concentrations of CQ plus desethylchloroquine (DCQ; the major CQ metabolite) higher than 100 ng/ml.

TOLLIP gene variant is associated with Plasmodium vivax malaria in the Brazilian Amazon.

Background: Toll-interacting protein is a negative regulator in the TLR signaling cascade, particularly by impeding the TLR2 and, TLR4 pathway. Recently, TOLLIP was shown to regulate human TLR signaling pathways. Two common TOLLIP polymorphisms (rs5743899 and rs3750920) were reported to be influencing IL-6, TNF and IL-10 expression.