Rationale for recommending a lower dose of primaquine as a Plasmodium falciparum gametocytocide in populations where G6PD deficiency is common

Abstract In areas of low malaria transmission, it is currently recommended that a single dose of primaquine (0.75 mg base/kg; 45 mg adult dose) be added to artemisinin combination treatment (ACT) in acute falciparum malaria to block malaria transmission. Review of studies of transmission-blocking ac...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: White Nicholas J, Qiao Li, Qi Gao, Luzzatto Lucio
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2012
Subjects:
Online Access:https://doi.org/10.1186/1475-2875-11-418
https://doaj.org/article/550f6523a40f43b4bdab1a813d619ca8
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Summary:Abstract In areas of low malaria transmission, it is currently recommended that a single dose of primaquine (0.75 mg base/kg; 45 mg adult dose) be added to artemisinin combination treatment (ACT) in acute falciparum malaria to block malaria transmission. Review of studies of transmission-blocking activity based on the infectivity of patients or volunteers to anopheline mosquitoes, and of haemolytic toxicity in glucose 6-dehydrogenase (G6PD) deficient subjects, suggests that a lower primaquine dose (0.25 mg base/kg) would be safer and equally effective. This lower dose could be deployed together with ACTs without G6PD testing wherever use of a specific gametocytocide is indicated.