Amphoe Mae Sot

Plasmodium vivax malaria is a common and serious cause of illness in tropical regions, especially in Southeast Asia where it accounts for over half of the global burden. This malaria type can relapse multiple times due to dormant liver forms, leading to severe health issues including anemia and pregnancy loss. The trial aims to determine if a higher 450 mg dose of tafenoquine combined with Artemisinin Combination Therapies ACTs is effective for treating P. vivax malaria, especially where chloroquine resistance limits treatment options. Participants will receive one of three treatments dihydroartemisinin-piperaquine plus 450 mg tafenoquine, chloroquine plus 450 mg tafenoquine, or artemether-lumefantrine plus 450 mg tafenoquine. Each drug combination is given using specific dosing schedules, such as weight-based doses of dihydroartemisinin-piperaquine over three days or chloroquine doses spread over three days. Tafenoquine is administered as a single 450 mg dose to improve convenience and adherence compared to traditional 14-day primaquine treatment. During the study, participants with confirmed P. vivax malaria will be monitored over four months with regular safety checks, blood tests, and pharmacokinetic assessments. Quantitative tests for G6PD enzyme activity will screen for risks before tafenoquine use. The main outcome is to compare the effectiveness of ACT plus tafenoquine against chloroquine plus tafenoquine in preventing malaria relapse. Researchers will also evaluate drug safety, tolerability, and oxidative activity over several time points.

Researchers are studying acute febrile illness in patients older than 28 days who live in rural areas of Laos, Myanmar, Thailand including the Thai-Myanmar border region, and Bangladesh. This observational study aims to describe the causes, clinical outcomes, and host biomarkers associated with these illnesses, which last 14 days or less. The study is part of a larger community-based network seeking to improve understanding and future interventions for febrile illness in low- and middle-income countries in South and Southeast Asia. The study involves two main parts Work Package A collects data from village health workers and local health facilities to understand the incidence and outcomes of febrile illness at the community level. Work Package B recruits patients seeking care at higher-level health facilities who may be more severely ill. In Work Package B, researchers collect various samples including venous blood and respiratory specimens for detailed diagnostic testing such as blood cultures, serological assays, molecular diagnostics, and host biomarker assays. Participants will be monitored for about one month to measure the prevalence of pathogens and recovery status. The study will analyze the association between host biomarkers and clinical outcomes to help create electronic decision-support tools for village health workers. These tools and other interventions will be tested later to improve assessment, triage, and treatment of patients with febrile illness. The total duration of participation and follow-up is approximately one month.