Amphoe Mae Sot

Plasmodium vivax malaria is a common and serious disease in the Greater Mekong Subregion, where it often causes repeated illness due to parasites hiding in the liver. This condition can lead to severe anemia and other complications, especially in young children and pregnant women. Researchers are studying whether a higher 450 mg dose of tafenoquine, a new single-dose liver-stage malaria treatment, can be effectively combined with Artemisinin Combination Therapies (ACTs) like Artemether-Lumefantrine or dihydroartemisinin-piperaquine (DHA-PPQ). This is important because previous data suggest ACTs might reduce tafenoquine's effectiveness, limiting treatment options in areas with chloroquine-resistant malaria. Participants in this phase 4 trial will be treated with one of three drug combinations: DHA-PPQ plus 450 mg tafenoquine, chloroquine plus 450 mg tafenoquine, or Artemether-Lumefantrine plus 450 mg tafenoquine. The dosing schedules vary by treatment: DHA-PPQ is given once daily in three divided doses based on weight, chloroquine is given in divided doses over three days, and Artemether-Lumefantrine is given twice daily for three days. Tafenoquine is administered as 4.5 tablets (450 mg) in all groups. The study aims to compare whether ACTs combined with tafenoquine are not less effective than chloroquine combined with tafenoquine in curing P. vivax malaria. Participants will be adults over 18 years old with confirmed P. vivax infection and normal glucose-6-phosphate dehydrogenase (G6PD) activity. They will be followed for four months to monitor malaria relapse and treatment safety. Researchers will perform quantitative G6PD testing, rapid diagnostic tests, and clinical assessments throughout the study. The primary goal is to determine if ACT plus tafenoquine is as effective as chloroquine plus tafenoquine in preventing malaria relapse by month four, with close safety monitoring and adherence support.

Researchers are investigating the causes and clinical outcomes of acute febrile illness in patients older than 28 days living in rural areas of Laos, Myanmar, Thailand, the Thai-Myanmar border region, and Bangladesh. The study focuses on patients presenting with fever lasting 14 days or less, aiming to better understand the burden and factors affecting febrile illness in these low- and middle-income communities where infectious diseases remain a major health concern. This observational study is part of the South and Southeast Asian Community-based Trials Network and is funded by the UK Wellcome Trust. The study is conducted in two parts: Work Package A collects data from village health workers and local health facilities on the incidence and outcomes of febrile illness in the community, while Work Package B recruits patients from higher-level health facilities who are likely more severely ill. In Work Package B, a wide range of specimens, including blood and respiratory samples, will be collected for detailed diagnostic testing such as blood cultures, serology, molecular diagnostics, and host biomarker assays. These data will help create electronic decision-support tools to aid health workers in patient assessment and treatment. Participants will be closely monitored during their visit to health facilities where samples will be collected over approximately one month to determine the prevalence of pathogens causing febrile illness. Researchers will gather clinical data and laboratory results to analyze causes, incidence, and outcomes of fever in these rural settings. The study aims to improve future interventions by providing a rich understanding of febrile illness in these populations, with follow-up and safety monitoring incorporated in the study design.

Researchers are studying febrile illness in rural communities across South and Southeast Asia, including Cambodia, Laos, Myanmar, and Bangladesh. This extensive study aims to understand how common febrile illness is, what causes it, and what effects it has on people living in these areas. The research is funded by the UK Wellcome Trust and seeks to gather information on febrile illness on a scale never before attempted in these regions. The study focuses on Work Package A (WP-A), which operates at the community level by involving village health workers and small health centers. Patients who show signs of fever are recruited and assessed for symptoms. Since collecting specimens for diagnosis is challenging in these rural settings, the study uses finger-prick blood tests similar to existing rapid diagnostic tests, while also collecting dried blood spots for further testing. This approach helps identify various pathogens causing the febrile illness. Participants will be observed over time to track the incidence and outcomes of febrile illness. Researchers will measure how often febrile illness occurs locally and overall during the two-year period, as well as mortality and morbidity within one month after the patient first presents to a health worker or facility. The study involves clinical assessments and specimen collection to help improve future diagnosis and treatment of febrile illnesses in these communities.