Forty percent of the world's population is at risk of Plasmodium vivax infection. Relapse is a feature of malaria caused by P. vivax and P. ovale due to the presence of the parasite's hypnozoite stage that allows it to stay dormant in the human liver. The associated morbidity and economic burden is high, as P. vivax causes severe anemia, miscarriage among pregnant women, malnutrition, and developmental delay in young children due to its chronic relapsing nature. Till recently, for more than 60 years the only licensed antimalarial with proven hypnozoitocidal activity was primaquine. The World Health Organization recommends a regimen of 3-day chloroquine plus 14 days of primaquine for radical cure. Poor adherence to the primaquine course limits its public health benefit on a large scale. Tafenoquine is an 8-aminoquinoline with slower elimination rate, hence a single dose of it is sufficient for hypnozoitocidal activity. Additionally, the schizontocidal activity of tafenoquine makes it a superior drug to the currently available antimalarials, which are mostly single stage specific. Recently, tafenoquine was approved in the USA and Australia for the radical cure of P. vivax malaria in patients aged ≥16 years who are receiving appropriate antimalarial therapy for acute P. vivax malaria, and for the prophylaxis of malaria in patients aged ≥18 years. We have reviewed the available literature of tafenoquine here, and this article explores the possibility of tafenoquine as a key tool for control and elimination of malaria.

IntroductionDepression is a common mental disorder in the elderly population, which significantly impacts their quality of life. However, correct estimates of its magnitude are not available in the elderly in India. The present systematic review and meta-analysis would attempt to estimate the prevalence of depression using diagnostic instruments among elderly persons aged 60 years and above.Methods and analysisSearches will be performed in PubMed, Scopus, Embase, Web of Science, CINAHL and PsycINFO. Community-based cross-sectional and cohort studies (2001 to September 2019) reporting the prevalence of depression in the elderly, using diagnostic instruments will be included. Studies conducted among chronic disease patients, in-hospital patients and special groups such as with disaster-stricken populations, and studies reporting the only one or two subcategories of depression, will be excluded. Disagreements in study selection and data abstraction will be resolved by consensus and arbitration by a third reviewer. AXIS critical appraisal tool will be used for quality assessment of individual studies. Findings of eligible studies will be pooled using fixed-effects or random-effects meta-analysis whichever is appropriate. Heterogeneity between studies will be examined by Cochran’s Q test and quantified by I² statistic. A cumulative meta-analysis will be used to detect temporal trends in the prevalence of depression and the effect of poor-quality studies on the pooled estimate. Publication bias will be assessed by visual inspection of funnel plots and the Egger test.Ethics and disseminationNo ethical approval will be needed because it will be a systematic review. Data from previously published studies will be retrieved and analysed. Findings will be disseminated through a peer-reviewed publication in a scientific journal and conferences.PROSPERO registration numberCRD42019138453.

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Maternal mortality remains a global health problem. Preeclampsia and eclampsia, major hypertensive disorders in pregnancy, remain the fourth leading cause of maternal mortality. The role of aspirin to prevent preeclampsia has been explored in the last 3 decades. This article summarizes the various studies done so far on the role of aspirin in preeclampsia and seeks to develop a hypothesis regarding the indication, dose and efficacy of aspirin therapy in the prevention of preeclampsia. Aspirin, when administered at 12-20 weeks of gestation at a dose of 75-150 mg seems to have a role in primary and secondary prevention of preeclampsia in high-risk pregnant women. The existing screening algorithms for preeclampsia have a high false positive rate. Therefore, a need for further research to develop a better screening algorithm for detection of women at a high risk of preeclampsia is warranted. The results, from the recent Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) study, reported better prevention of preeclampsia with a 150 mg dose of aspirin. Hence, more data from multicentric randomized controlled trials are required to establish the safety and higher effect size of 120-150 mg dose aspirin compared to the 75-100 mg dose of aspirin for prevention of preterm preeclampsia.

Background: With the advent of the COVID-19 pandemic, prevention and control of noncommunicable diseases (NCDs) have become even more critical as NCDs are major risk factors for patients with COVID-19. Therefore, this study was planned with the following objectives: (i) To assess adherence with chronic disease care among patients with NCDs. (ii) To determine the factors associated with adherence with chronic disease care among patients with NCDs during COVID-19 nationwide lockdown. Materials and Methods: This was a hospital-based cross-sectional study conducted in the NCD prevention clinic of All India Institute of Medical Sciences, Bhubaneswar, during July 2020–August 2020. A total of 210 patients were studied. Patients were interviewed both at the clinic and telephonically; those who had scheduled visits did not make it. Out of 210 patients, 105 participants were interviewed face to face in the hospital in the NCD prevention clinic. The other 105 patients were interviewed telephonically who did not attend the clinic during follow-up. Results: All the participants (210) had diabetes mellitus, and 44.8% of participants had accompanying hypertension. One-fourth of participants could not follow the dietary practices advised by the doctor during the lockdown. Similarly, 42% of participants could not maintain moderate-intensity physical activity (30 min) during the lockdown period. The period prevalence of nonadherence to prescribed drugs/medicines in our sample was 45.71% (95% confidence intervals [CI] 38.84–52.71). Participants with more than one NCDs had a 52% less chance to stop the drugs/medications during the national lockdown period than participants with one NCD (adjusted odds ratio 0.48, 95% CI 0.27–0.83). Conclusions: The continuum of chronic disease care of NCD patients has been affected by COVID-19 nationwide lockdown. Appropriate planning and provision of chronic disease care are essential during the lockdown and similar situations.