No abstract

No abstract

The development of resistance to antimalarials is a major challenge for global malaria control. Artemisinin-based combination therapies, the newest class of antimalarials, are used worldwide but there have been reports of artemisinin resistance in Southeast Asia. In February through May 2013, we conducted open-label, nonrandomized therapeutic efficacy studies of artemetherlumefantrine (AL) and dihydroartemisinin-piperaquine (DP) in Zaire and Uíge Provinces in northern Angola. The parasitological and clinical responses to treatment in children with uncomplicated Plasmodium falciparum monoinfection were measured over 28 days, and the main outcome was a PCR-corrected adequate clinical and parasitological response (ACPR) proportion on day 28. Parasites from treatment failures were analyzed for the presence of putative molecular markers of resistance to lumefantrine and artemisinins, including the recently identified mutations in the K13 propeller gene. In the 320 children finishing the study, 25 treatment failures were observed: 24 in the AL arms and 1 in the DP arm. The PCR-corrected ACPR proportions on day 28 for AL were 88% (95% confidence interval [CI], 78 to 95%) in Zaire and 97% (91 to 100%) in Uíge. For DP, the proportions were 100% (95 to 100%) in Zaire, and 100% (96 to 100%) in Uíge. None of the treatment failures had molecular evidence of artemisinin resistance. In contrast, 91% of AL late-treatment failures had markers associated with lumefantrine resistance on the day of failure. The absence of molecular markers for artemisinin resistance and the observed efficacies of both drug combinations suggest no evidence of artemisinin resistance in northern Angola. There is evidence of increased lumefantrine resistance in Zaire, which should continue to be monitored.

D uring January 2020, persons in Thailand were tested for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection if they had a combination of fever or respiratory illness and a history of travel to Wuhan, China. Persons determined to be close contacts of a laboratory-confirmed coronavirus disease (COVID-19) case-patient also were tested during enrollment into contact tracing. Clinicians were able to request testing if they had a concern regarding persons who were exposed to travelers. During January 8-31, 2020, Bamrasnaradura Infectious Diseases Institute, the national infectious disease referral hospital in Bangkok, admitted 11 patients with laboratoryconfirmed COVID-19. We describe clinical features, clinical management, and results of serial reverse transcription PCR (RT-PCR) testing for SARS-CoV-2 RNA for these patients.