The Lancet Infectious Diseases

📢 New evidence of the effectiveness of both sulfadoxine-pyrimethamine combined with amodiaquine (SPAQ) and dihydroartemisinin-piperaquine (DP) for seasonal malaria chemoprevention (SMC) in protecting children under 5 years of age from malaria in areas of high and seasonal transmission. 🔎 Nuwa Anthony and colleagues have reported the findings of a three-arm, open-label, non-inferiority, and superiority, cluster-randomised controlled trial conducted in the Karamoja region, Northeastern Uganda among children 3–59 and 6–59 months for SPAQ and DP, respectively. The trial compared five monthly cycles of SPAQ with DP for SMC. ⚖️ Trial was conducted in 427 villages. Of these villages, 380 were randomly assigned to either SPAQ or DP, while the remaining 47 village-clusters were assigned to the control arm. There was detailed follow-up of 3629 children to assess the primary endpoint: rapid-diagnostic test (RDT) or malaria microscopy confirmed clinical malaria. 💡 Researchers demonstrated that compared to the control group, both interventions demonstrated remarkable protective efficacy against confirmed malaria cases—94% (hazard ratio [HR] 0·06 [95% CI 0·04–0·08]; p<0·001) for SPAQ and 96% (0·04 [0·03–0·06]; p<0·001) for DP.  The effectiveness of DP was non-inferior to SPAQ. 🔦 SMC is a cornerstone of malaria control but in East and southern Africa its implementation with SPAQ has been limited because of the high level of resistance to sulfadoxine-pyrimethamine in the area. This trial is part of a programme to introduce SMC in the region and is the first to test an alternative to SPAQ to obviate the issue of resistance. It remains to be seen if these results alone will be sufficient to drive widespread SMC adoption in East and Southern Africa in line with WHO guidelines for SMC implementation. 📖 You can read the paper here: bit.ly/4ayQaxQ 📖 You can read the insightful comment by Feiko ter Kuile here: bit.ly/4gfMKBx #malaria #sulfadoxine #pyrimethamine #amodiaquine #dihydroartemisinin #piperaquine Malaria Consortium, Nuwa Anthony, Dr Kevin Baker, Richard Kajubi, Katherine Theiss-Nyland, Odongo Musa, tonny kyagulanyi, David Salandini Odong, ASUA VICTOR, Maureen Nakirunda, Christian Rassi, Rutazaana Damian, Achuma Richard, Godfrey Magumba, Adoke Yeka, James Tibenderana

📢Personal View-A framework towards implementation of sequencing for antimicrobial-resistant and other health-care-associated pathogens ⚖️ The 3rd Geneva Infection Prevention and Control (IPC) Think Tank brought together >60 experts from 16 countries to identify gaps, propose solutions, and set priorities for the use of NGS for HAI/antimicrobial resistant pathogens. The major deliverable of the meeting was a proposed framework for implementing sequencing of HAI pathogens, specifically those harbouring AR mechanisms with the following critical components: wet lab quality, sequence data quality, database and tool selection, bioinformatic analyses, data sharing, and NGS data integration to support public health and IPC actions. 💡 In this Personal View, Alison Halpin and co-authors detail the framework and discuss the context for global implementation, specifically in low- and middle-income countries. Three categories of NGS application, including individual/diagnostic, outbreak/response, and surveillance/monitoring were identified. A framework based on best practice, collaboration and successful implementation is proposed. Barriers for implementation and possible solutions are also discussed. This personal view aims to foster continued discussion on the topic. Authors argue that creative approaches are required to ensure that the need for perfection does not derail current opportunities to make use of NGS and bioinformatics as a tool to prevent HAIs, combat AMR, and save lives. The paper can be found here: https://bit.ly/4awdQ5W #AMR, #infections, #NGS, #bioinformatics, #LMICs Centers for Disease Control and Prevention, University Hospitals Geneva Medical Center, Ineos Oxford Institute for Antimicrobial Research, Institute for Antimicrobial Resistance, University of Virginia, Universitätsspital Zürich, University of Ibadan, HUG - Hopitaux Universitaires de Genève, University of Cambridge School of Clinical Medicine, US PUBLIC HEALTH SERVICE, 3rd Geneva Infection Prevention and Control (IPC) Think Tank

🚀Promising Phase II/III trial of albendazole and ivermectin (fixed doses) co-formulation for treatment of soil-transmitted helminthiases. 🔎 Alejandro Krolewiecki and colleagues have reported the results of an adaptive phase 2/3 randomised controlled superiority trial comparing the standard regimen of a single dose of 400 mg albendazole versus two experimental fixed-dose co-formulations (FDCs) of albendazole and ivermectin for the treatment of soil-transmitted helminthiases. ⚖️ Trial was conducted in 15 schools in Kenya, Mozambique, and Ethiopia enrolling 1001 children/adolescents (aged 518 years) with infection. The primary outcome of phase 2 (conducted in Kenya only) was safety during the first 3 hours after the intervention and for 7 days, and the primary outcome of phase 3 was cure rate of Trichuris trichiura. Researchers demonstrated the safety and efficacy above the current standard for the treatment of geohelminths. For Trichuris trichiura, cure rate of the triple dose and the single dose both had higher cure rate (97·2% and 82·9%, respectively) compared with albendazole alone (35·9%). Difference between groups was 47·0 (36·6 to 56·5) percentage points for the single dose and 61·3 (51·9 to 69·8) for the three-day dose. 💡 FDCs may encourage the use of a safe and effective combination treatment instead of monotherapy in soil-transmitted helminth control programmes to enhance preventive chemotherapy against soil-transmitted helminths, including Strongyloides stercoralis, and slow down the emergence of resistance. Questions for wider implementation are affordability, large scale accessibility, and generalizability of the findings. Data has been submitted to the European Medicines Agency for regulatory approval. Here is the paper: https://bit.ly/40EBE4A Here is the comment by Dora Buonfrate: bit.ly/4gYURnj #albendazole #ivermectin #helminths #MundoSano #EDCTP

The Lancet Infectious Diseases is on LinkedIn! 🌟 As a world-leading infectious diseases journal, we publish original research that advocates change in, or illuminates, infectious disease clinical practice. We also publish informative reviews on any topic connected with infectious diseases and human health. Our latest Editorial reflects on lessons from the 2014–16 Ebola virus outbreak. Explore the January issue: https://hubs.li/Q032qJGj0 And hit the follow button 👍 Alt: Cover of The Lancet Infectious Diseases’ January 2025 issue, showing an illustration of a woman walking across a vaccine that separates her from the jaws of a rabid dog. By Lillian Li. #InfectiousDiseases #MedicalResearch #ClinicalPractice