Preliminary Study on Open Labelled Randomized Controlled Trial of the Safety and Efficacy of Hydroxychloroquine and Chloroquine Phosphate for the Treatment of Persons Infected with 2019 Coronavirus Disease in Nigeria.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a causative agent of COVID-19 is a leading cause of ill-health and deaths worldwide. Currently, COVID-19 has no known widely approved therapeutics. Thus, the need for effective treatment. OBJECTIVES: We investigated the safety and efficacy of two (2) therapeutic agents; chloroquine phosphate (CQ), 2- hydroxychloroquine (HCQ) and a control (standard supportive therapy) among hospitalized adults with COVID-19. METHODS: The clinical trial was done in accordance to the World Health Organization master protocol for investigational therapeutics for COVID-19. Atotal of 40 participants with laboratory-confirmed positive COVID-19 were enrolled. Blood samples and oropharyngeal (OP) swabs were obtained on days 1,3,15 and 29 for safety and efficacy assessments. RESULTS: The baseline demographics showed that the median ages in years (range) were 45 (31-57) in CQ, 45 (36.5-60.5) in HCQ, 43 (39.5-67.0) and 44.5 (25.3-51.3) in the control (P<0.042).At randomization, seven (7) participants were asymptomatic, thirty-three (33) had mild symptoms, eight (8) had moderate symptoms while three (3) had severe symptoms. The average day of conversion to negative COVID-19 was 15.5 days for CQ, 16 days for HCQ and 18 days for the control(P=0.036). CONCLUSION: The safety assessment revealed no adverse effect of the drugs in COVID-19 patients after treatment. These findings proved that chloroquine and hydroxychloroquine are effective for the treatment of COVID-19 among hospitalized adults. It also confirmed that they are safe.

CONTEXTE: Le coronavirus du syndrome respiratoire aigu sévère 2 (SARS-CoV-2),agentcausaldelaCOVID-19, est l'unedes principales causes demaladie et de décès dans le monde. À l'heure actuelle, il n'existe aucun traitement largement approuvé pour la COVID-19. Ainsi, ilya un besoin de traitement efficace. OBJECTIFS: Nous avons étudié l'innocuité et l'efficacité de deux (2) agents thérapeutiques, le phosphate de chloroquine (CQ) et l'hydroxychloroquine (HCQ), ainsi qu'un groupe témoin (traitement de soutien standard) chez des adultes hospitalisés atteints de la COVID-19.MÉTHODES: L'essai clinique a été mené conformément au protocole maître de l'Organisation mondiale de la santé pour les thérapeutiques à l'étude de la COVID-19. Au total, 40 participants atteints de la COVID-19, confirmée en laboratoire, ont été in scrits. Des échantillons de sang et des prélèvements oropharyngés (PO) ont été effectuésauxjours1,3,15et29pourévaluerl'innocuitéetl'efficacité. RÉSULTATS: Les données démographiques initiales ont révélé que l'âge médian en années (plage) était de 45 (31-57) pour le groupe CQ, de 45 (36,5-60,5) pour le groupe HCQ, de 43 (39,5-67,0) et de 44,5 (25,3-51,3) pour le groupe témoin (P<0,042). À la randomisation, sept (7) participants étaient asymptomatiques, trente-trois (33) présentaient des symptômes bénins, huit(8) avaient des symptômes modérés, tandis que trois(3) avaient des symptômes graves. Le jour moyende conversionentest COVID-19 négatif était de 15,5 jours pour le groupe CQ, de 16 jours pour le groupe HCQ et de 18 jours pourle groupe témoin (P=0,036). CONCLUSION: L'évaluation de la sécurité n'a révélé aucun effet indésirable des médicaments chez les patients atteints de la COVID-19 après le traitement. Ces conclusions ont prouvé que la chloroquine et l'hydroxychloroquine sont efficaces pour le traitement de la COVID-19 chez les adultes hospitalisés. Cela a également confirmé qu' ilssont sûrs. Mots-clés: COVID-19, SARS-CoV-2, essai clinique, innocuité, efficacité, thérapeutiques.

Test for association between dieldrin resistance and 2La inversion polymorphism in Anopheles coluzzii from Lagos, Nigeria.

The assortment of paracentric chromosomal inversion 2La is associated with the maintenance of dieldrin resistance in laboratory colonies of the malaria vector Anopheles gambiae. This association has not been tested in field populations. The aim of this study was to test the association between inversion 2La and dieldrin resistance in a field population of An. coluzzii in Nigeria. Field collected immature stages of Anopheles were raised to adults and exposed to 4% dieldrin according to WHO criteria. Knockdown was recorded at 10 min intervals for 1 hour and final mortality was recorded 24 hours post exposure. Species and inversion 2La diagnostic PCR assays were conducted on the resistant and susceptible mosquitoes. The mosquitoes were highly resistant to 4% dieldrin (17.1% knock down and 25.7% final mortality; KDT50 and KDT95 calculated as 170 and 1, 514 minutes respectively). Frequencies of 2La in both the resistant and susceptible cohorts assorted within HardyWeinberg estimates (χ2=1.32, p=0.8 for dead/susceptible mosquitoes and χ2=2.54, p=0.5 for survivors or resistant mosquitoes). However, a higher number of heterozygous mosquitoes were observed in the resistant cohort compared to the susceptible, with significant variation in karyotype frequencies (χ2=11.08, DF=2, p<0.05) and a significantly higher frequency of the 2La inversion arrangement in the resistant cohort (Pearson's χ2 = 4.58, p = 0.03.). These data are the first to associate paracentric chromosome inversion 2La and dieldrin resistance in field population of An. coluzzii. Dieldrin resistance shows a weak but significant association with 2La whose assortment is affected by positive heterosis. Variation in the assortment of 2La inversion arrangements between resistant and susceptible cohorts of this An. coluzzii population suggests that dieldrin resistance is at least partially linked to inversion 2La which may explain the persistence of dieldrin resistance in this population despite a significant absence of selection for resistance to this insecticide.

Test for association between dieldrin resistance and 2La inversion polymorphism in Anopheles coluzzii from Lagos, Nigeria

@#The assortment of paracentric chromosomal inversion 2La is associated with the maintenance of dieldrin resistance in laboratory colonies of the malaria vector Anopheles gambiae. This association has not been tested in field populations. The aim of this study was to test the association between inversion 2La and dieldrin resistance in a field population of An. coluzzii in Nigeria. Field collected immature stages of Anopheles were raised to adults and exposed to 4% dieldrin according to WHO criteria. Knockdown was recorded at 10 min intervals for 1 hour and final mortality was recorded 24 hours post exposure. Species and inversion 2La diagnostic PCR assays were conducted on the resistant and susceptible mosquitoes. The mosquitoes were highly resistant to 4% dieldrin (17.1% knock down and 25.7% final mortality; KDT50 and KDT95 calculated as 170 and 1, 514 minutes respectively). Frequencies of 2La in both the resistant and susceptible cohorts assorted within Hardy- Weinberg estimates (χ2=1.32, p=0.8 for dead/susceptible mosquitoes and χ2=2.54, p=0.5 for survivors or resistant mosquitoes). However, a higher number of heterozygous mosquitoes were observed in the resistant cohort compared to the susceptible, with significant variation in karyotype frequencies (χ2=11.08, DF=2, p<0.05) and a significantly higher frequency of the 2La inversion arrangement in the resistant cohort (Pearson’s χ2 = 4.58, p = 0.03.). These data are the first to associate paracentric chromosome inversion 2La and dieldrin resistance in field population of An. coluzzii. Dieldrin resistance shows a weak but significant association with 2La whose assortment is affected by positive heterosis. Variation in the assortment of 2La inversion arrangements between resistant and susceptible cohorts of this An. coluzzii population suggests that dieldrin resistance is at least partially linked to inversion 2La which may explain the persistence of dieldrin resistance in this population despite a significant absence of selection for resistance to this insecticide.