Naphthoquine-azithromycin shows efficacy against malaria in phase 3 trial
A phase 3 clinical trial involving 531 people living along the China-Myanmar border has shown that the antimalarial-antibacterial drug combination naphthoquine-azithromycin (NQAZ) is effective in preventing malarial Plasmodium infections.
Plasmodium species are parasites that spread bacteria to vertebrates via blood-sucking insects such as mosquitoes. The trial, published yesterday in Clinical Infectious Diseases, found that only 3 of 319 volunteers (0.9%) in the group receiving NQAZ tablets tested positive for falciparum malaria on blood smear, versus 46 of 312 (14.7%) in the placebo group.
In an intent-to-treat analysis, single-dose monthly NQAZ had a prophylactic effectiveness of 93.6% against malarial Plasmodium (95% confidence interval [CI], 91.7% to 95.5%). A per-protocol analysis showed that NQAZ had 93.0% effectiveness (95% CI, 91.0% to 95.1%).
NQAZ prevented 100% of infections from relapsing malaria caused by Plasmodium vivax and P ovale. Among subjects receiving NQAZ, 5.6% had short-term elevations of liver transaminases (indicating liver damage), compared with 2.2% of the placebo group (P > 0.05).
"Monthly prophylaxis with NQAZ tablets was well tolerated and highly effective for preventing Plasmodium infections," they wrote. "It may prove useful for eliminating P. vivax in areas with a high prevalence of glucose-6-phosphate dehydrogenase deficiency in the population," a condition that causes red blood cells to rupture and die.
Jul 20 Clin Infect Dis abstract
WHO: global flu levels low for this time of year
Global flu activity is lower than expected for this time of year, and the flu season hasn't started in the Southern Hemisphere, which is in the midst of its winter season, the World Health Organization (WHO) said yesterday in a regular update. It included the caveats that the COVID-19 pandemic may be affecting health behaviors and testing capacity.
Sporadic flu detections were reported in the Caribbean and Central American regions, though severe acute respiratory infection (SARI) activity is elevated in some countries, which likely reflects COVID-19 activity.
Tropical parts of South America and Africa also reported sporadic flu cases, but no flu detections were reported in Southern Asia or Southeast Asia. In the Northern Hemisphere, flu remained at interseasonal levels.
New Zealand reports slight increases in flulike illness and SARI for June, but flu positives were low for this time of year, with other respiratory viruses such as rhinovirus found in tested samples.
Of specimens tested through roughly the last part of June and into the first week of July, 43 were positive for flu, with influenza A and influenza B equally represented. The one subtyped influenza A virus was 2009 H1N1.
Jul 20 WHO global flu update