BACKGROUND Tafenoquine, a single-dose therapy for Plasmodium vivax malaria, has been associated with relapse prevention through the clearance of P. vivax parasitemia and hypnozoites, termed “radical cure.” METHODS We performed a phase 3, prospective, double-blind, double-dummy, randomized, controlled trial to compare tafenoquine with primaquine in terms of safety and efficacy. The trial was conducted at seven hospitals or clinics in Peru, Brazil, Colombia, Vietnam, and Thailand and involved patients with normal glucose-6-phosphate dehydrogenase (G6PD) enzyme activity and female patients with moderate G6PD enzyme deficiency; all patients had confirmed P. vivax parasitemia. The patients were randomly assigned, in a 2:1 ratio, to receive a single 300-mg dose of tafenoquine or 15 mg of primaquine once daily for 14 days (administered under supervision); all patients received a 3-day course of chloroquine and were followed for 180 days. The primary safety outcome was a protocol-defined decrease in the hemoglobin level (>3.0 g per deciliter or ≥30% from baseline or to a level of <6.0 g per deciliter). Freedom from recurrence of P. vivax parasitemia at 6 months was the primary efficacy outcome in a planned patient-level meta-analysis of the current trial and another phase 3 trial of tafenoquine and primaquine (per-protocol populations), and an odds ratio for recurrence of 1.45 (tafenoquine vs. primaquine) was used as a noninferiority margin. RESULTS A protocol-defined decrease in the hemoglobin level occurred in 4 of 166 patients (2.4%; 95% confidence interval [CI], 0.9 to 6.0) in the tafenoquine group and in 1 of 85 patients (1.2%; 95% CI, 0.2 to 6.4) in the primaquine group, for a between-group difference of 1.2 percentage points (95% CI, −4.2 to 5.0). In the patient-level meta-analysis, the percentage of patients who were free from recurrence at 6 months was 67.0% (95% CI, 61.0 to 72.3) among the 426 patients in the tafenoquine group and 72.8% (95% CI, 65.6 to 78.8) among the 214 patients in the primaquine group. The efficacy of tafenoquine was not shown to be noninferior to that of primaquine (odds ratio for recurrence, 1.81; 95% CI, 0.82 to 3.96). CONCLUSIONS Among patients with normal G6PD enzyme activity, the decline in hemoglobin level with tafenoquine did not differ significantly from that with primaquine. Tafenoquine showed efficacy for the radical cure of P. vivax malaria, although tafenoquine was not shown to be noninferior to primaquine. (Funded by GlaxoSmithKline and Medicines for Malaria Venture; GATHER ClinicalTrials.gov number, NCT02216123.)

Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease, and risk communication is one of several public health emergency responses. During the pandemic, many migrant workers in Thailand experienced barriers that hamper access to health information. This study aims to explore factors related to the outcomes of health risk communication, including awareness of public health measures and preventive practices. We conducted a cross-sectional survey on migrants between January and April 2021 using cluster sampling in Phuket, Ranong, and Samut Sakhon. In the descriptive analysis, we presented the median, proportion, and ratio, while in the inferential analysis, we employed a logistic regression with robust standard errors. Although a total of 303 participants were initially included in this study, the final number was narrowed down to 288 samples due to insufficient information required for the analysis. Frequent reception of health information and primary school education showed a statistically significant association with preventive practices. Middle-aged migrant workers demonstrated a significantly lower level of preventive practices than younger migrant workers. A longer stay in Thailand was significantly related to a lower degree of awareness toward public health measures. Thus, it is necessary to promote the accessibility of health information among migrant workers in Thailand, especially those who have lived in Thailand for more than eight years, are older, and have no formal education.

Paragonimiasis is a food-born zoonotic parasitosis caused by Paragonimus spp. Six cases of reemerging paragonimiasis within the Karan hill-tribe near the Thai–Myanmar border were evaluated to review clinical manifestations, predisposing factors, and treatment regimens. All patients tested positive for paragonimiasis eggs and presented with an array of symptoms, including chronic cough, hemoptysis, peripheral eosinophilia, and thoracic radiograph abnormalities. All fully recovered after a 2- to 5-day course of 75 to 80 mg/kg/day praziquantel. We conclude that paragonimiasis should be considered during differential diagnoses to promote early treatment and to prevent misdiagnosis of reemerging or sporadic cases. This applies particularly to endemic regions and high-risk groups known to habitually consume raw or undercooked intermediate or paratenic hosts.

On 23 Mar 2020, the Situation Awareness Team of the Emergency Operations Center, Department of Disease Control, was notified that a 44-year-old Thai male, who was infected with coronavirus disease 2019 (COVID-19), had died in a private hospital in Bangkok, and there was a suspicion that some healthcare workers were infected with SARS-CoV-2 following his death. A descriptive cross-sectional study was conducted. We reviewed medical records of the index case, interviewed relatives of the index case, and performed contact tracing using a standard questionnaire. We could identify 206 high-risk contacts. Twenty out of 206 high-risk contacts were then found to be infected with SARS-CoV-2. Fifteen of them were healthcare workers, two of them were current inpatients, and the other three were household contacts. The likely cause of disease spreading was the missed diagnosis of COVID-19 as the index case did not present with upper respiratory tract symptoms at the first visit to the hospital. Meal sharing among healthcare workers and sharing of a portable chest X-ray machine without proper protective equipment potentially served as other causes of COVID-19 spreading.