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JOINT INTERNATIONAL TROPICAL MEDICINE MEETING 2018 “INNOVATION, TRANSLATION, AND IMPACT IN TROPICAL MEDICINE” 12 – 14 DECEMBER 2018 AMARI WATERGATE HOTEL, BANGKOK, THAILAND ABSTRACTS Oral Presentations J I T M M 2 0 1 8 Organizers 4 Faculty of Tropical Medicine, Mahidol University 4 SEAMEO TROPMED Network 4 TROPMED Alumni Association 4 The Parasitology and Tropical Medicine Association of Thailand Co-organizers 9 Department of Disease Control Ministry of Public Health (MOPH) 9 Mahidol - Oxford Tropical Medicine Research Unit (MORU) 2 Wednesday 12 December 2018 Opening Session 09.00-09.45 Watergate Ballroom OPENING CEREMONY BY ORGANIZERS AND CO-ORGANIZERS Report by: Prof. Srivicha Krudsood Chair, JITMM2018 Scientific Committee WELCOME ADDRESS Dr. Sombat Thanphasertsuk Senior Expert in Prevention Medicine, Department of Disease Control, Thailand Ministry of Public Health WELCOME ADDRESS Mr. David Burton Chief Operating Officer, Mahidol-Oxford Tropical Medicine Research Unit (MORU) OPENING REMARKS Assoc. Prof. Pratap Singhasivanon Chairman, JITMM2018 Organizing Committee TROPMED Alumni Award Presentation Presented by: Assoc. Prof. Supranee Changbumrung Joint International Tropical Medicine Meeting (JITMM) 2018 “INNOVATION, TRANSLATION, AND IMPACT IN TROPICAL MEDICINE” 3 AWARD RECIPIENTS: Prof. Akira Kaneko Professor of Global Health, Department of Microbiology, Tumor and Cell biology, Karolinska Institutet, Sweden Prof. Dr. Tawadchai Suppadit Vice President, Planning and Development Strategies, Walailak University, Thailand Dr. Twatchai Srestasupana Director, Maesot General Hospital, Mae Sot, Tak, Thailand Joint International Tropical Medicine Meeting (JITMM) 2018 “INNOVATION, TRANSLATION, AND IMPACT IN TROPICAL MEDICINE” 4 Wednesday 12 December 2018 09.45-10.30 Watergate Ballroom S1: The 24th Chamlong-Tranakchit Lecture Chairperson: Pratap Singhasivanon Keynote Speaker: The safe and effective radical cure of malaria Prof. Ric Price Menzies School of Health Research, Darwin, Australia University of Oxford, United Kingdom Joint International Tropical Medicine Meeting (JITMM) 2018 “INNOVATION, TRANSLATION, AND IMPACT IN TROPICAL MEDICINE” Oral Presentations 5 ׀ ABSTRACTS Abstract No. : ABS0001272 The safe and effective radical cure of malaria Ric Price1,2 1 Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK; 2 Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia The leaders of 18 malaria endemic countries have set ambitious goals to eliminate malaria from the Asia Pacific region by 2030. Whilst there has been significant progress in reducing the burden of malaria, these gains are fragile. The ultimate goal of malaria elimination is threatened by a variety of challenges, particularly the spread of multidrug resistant P. falciparum and a rising proportion of infections due to non-falciparum malaria. These challenges highlight the importance of the main themes of this conference: innovation, translation, and impact. The timely elimination of malaria from the Asia Pacific will require expansion of malaria control activities to include active case detection and the widespread implementation of the effective radical cure of malaria, in which all stages of the parasite are targeted. Vivax’s ability to form dormant liver stages (hypnozoites) and to recur weeks to months after a primary infection requires treatment of both the blood and liver stages of the parasite. Currently, the only widely available drug to eliminate hypnozoites from the human host is primaquine a drug that can cause significant risk of haemolysis in individuals with G6PD deficiency. The prolonged treatment course and requirement for G6PD testing are major obstacles to healthcare providers, who are often reluctant to prescribe PQ, and patients, who are reluctant to take a full course of treatment. New tools have been developed to overcome these, including novel point of care devices and short course treatment regimens. These innovations will be discussed with regard to their translation into policy and their impact upon the burden of disease. Keyword : malaria, vivax, radical cure Joint International Tropical Medicine Meeting (JITMM) 2018 “INNOVATION, TRANSLATION, AND IMPACT IN TROPICAL MEDICINE” 6 Wednesday 12 December 2018 11.00-12.30 Room A S2: Ivermectin for malaria elimination Chairpersons: 1. Kesinee Chotivanich 2. Joel Tarning Invited Speakers: Ivermectin for malaria elimination - clinical trials Kevin Kobylinski Armed Forces Research Institute of Medical Sciences (AFRIMS) Evaluating the effect of ivermectin B1a and B1b compounds against the malaria vector Anopheles dirus Narenrit Wamaket Armed Forces Research Institute of Medical Sciences (AFRIMS) Ivermectin metabolites Phornpimon Tipthara Mahidol-Oxford Tropical Medicine Research Unit (MORU) Ivermectin inhibits P. cynomolgi and P. falciparum liver stage development John H Adams University of South Florida Joint International Tropical Medicine Meeting (JITMM) 2018 “INNOVATION, TRANSLATION, AND IMPACT IN TROPICAL MEDICINE” Oral Presentations 7 ׀ ABSTRACTS Abstract No. : ABS0001316 Ivermectin for Malaria Elimination - Clinical Trials Kevin C. Kobylinski1, Podjanee Jittamala2, Borimas Hanboonkunupakarn3,4, Sasithon Pukrittayakamee3, Kanchana Pantuwatana1, Siriporn Phasomkusolsil1, Silas A. Davidson1, Markus Winterberg4,5, Richard Hoglund4,5, Mavuto Mukaka4,5, Rob W. van der Pluijm4,5, Arjen Dondorp4,5, Nicholas P. J. Day4,5, Nicholas J. White4,5, Joel Tarning4,5 1 Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand 2 Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 3 Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 4 Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 5 Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom Ivermectin mass drug administration is being evaluated as a potential new vector control tool to aid malaria elimination efforts around the globe. Two clinical trials have recently been completed investigating the safety, tolerability, pharmacokinetics, and mosquito-lethal effect of ivermectin and dihydroartemisinin-piperaquine. A study in Kenya evaluated three day regimens of ivermectin at 300 or 600 μg/kg with dihydroartemisinin-piperaquine in Plasmodium falciparum infected persons, while a study in Thailand evaluated single dose administration of ivermectin at 400 μg/kg with dihydroartemisinin- piperaquine and primaquine in healthy volunteers. In a few volunteers, there was an increase in liver enzymes when ivermectin and dihydroartemisinin- piperaquine were co-administered which requires further investigation. Interestingly, both studies observed much higher than initially predicted ivermectin mosquito-lethal effects. Pharmacokinetic analyses demonstrated that ivermectin bioavailability was substantially increased when co- administered with dihydroartemisinin-piperaquine. Another contributing factor to increased mosquito lethality could be the possibility of ivermectin metabolites with mosquito-lethal effect. Several ivermectin mass drug administration field trials for malaria control are underway in Africa and Southeast Asia, each with their own unique approaches to control malaria which will be presented here. Keyword : Ivermectin, Plasmodium falciparum, malaria, Africa, Southeast Asia Joint International Tropical Medicine Meeting (JITMM) 2018 “INNOVATION, TRANSLATION, AND IMPACT IN TROPICAL MEDICINE” Oral Presentations ׀ ABSTRACTS 8 Abstract No. : ABS0001317 Evaluating the effect of Ivermectin B1a and B1b compounds against the malaria vector Anopheles dirus 1,2 Narenrit Wamaket , Oranicha Khamprapa 1,2, Siriporn Phasomkusolsil 2, Silas Davidson 2, Patchara Sriwichai 3, Phornpimon Tipthara 4, Markus Winterberg 4, Joel Tarning 4, Nicholas White 4, Jetsumon Sattabongkot 1, Kevin Kobylinski 2 1 Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University 2 Department of Entomology, Armed Forces Research Institute of Medical Sciences 3 Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University 4 Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University Ivermectin (IVM) is particularly potent against Anopheline mosquitoes, causing significant mortality, delayed re-feeding, and reduced fertility when ingested through a blood meal. In nature, IVM is a mixture of two homologs, 22, 23- dihydroavermectin B1a (IVM B1a) and 22, 23-dihydroavermectin B1b (IVM B1b) at a ratio of >90% and <10% respectively. Both structures are metabolized by similar pathways in the vertebrate. A recent study in snails demonstrated that the minor IVM B1b is the lethal component, while the major IVM B1a component had no effect. Here, IVM compounds in vitro activity was assessed by spiking human blood with various concentrations of IVM parent compound, IVM B1a and IVM B1b, blood feeding to Anopheles dirus and monitoring subsequent mortality to determine the lethal concentration that kills 50% (LC50) of mosquitoes. This study present for the first time, the in vitro impact of IVM B1a, and IVM B1b on An. dirus survival. These results will be used to guide discovery of which IVM metabolites possess mosquito-lethal effect. Keyword : Ivermectin