Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency.
Background The World Health Organization recommends that primaquine should be given once weekly for 8-weeks to patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase (G6PD) deficiency, but data on its antirelapse efficacy and safety are limited. Methods Within the context of a...
Published in: | PLOS Neglected Tropical Diseases |
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2023
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ftdoajarticles:oai:doaj.org/article:78102e14bb3e47dbbf049aebb8955204 2023-11-05T03:40:10+01:00 Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. Walter R J Taylor Niamh Meagher Benedikt Ley Kamala Thriemer Germana Bancone Ari Satyagraha Ashenafi Assefa Krisin Chand Nguyen Hoang Chau Mehul Dhorda Tamiru S Degaga Lenny L Ekawati Asrat Hailu Mohammad Anwar Hasanzai Mohammad Nader Naddim Ayodhia Pitaloka Pasaribu Awab Ghulam Rahim Inge Sutanto Ngo Viet Thanh Nguyen Thi Tuyet-Trinh Naomi Waithira Adugna Woyessa Arjen Dondorp Lorenz von Seidlein Julie A Simpson Nicholas J White J Kevin Baird Nicholas P Day Ric N Price 2023-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0011522 https://doaj.org/article/78102e14bb3e47dbbf049aebb8955204 EN eng Public Library of Science (PLoS) https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011522&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011522 https://doaj.org/article/78102e14bb3e47dbbf049aebb8955204 PLoS Neglected Tropical Diseases, Vol 17, Iss 9, p e0011522 (2023) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2023 ftdoajarticles https://doi.org/10.1371/journal.pntd.0011522 2023-10-08T00:37:57Z Background The World Health Organization recommends that primaquine should be given once weekly for 8-weeks to patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase (G6PD) deficiency, but data on its antirelapse efficacy and safety are limited. Methods Within the context of a multicentre, randomised clinical trial of two primaquine regimens in P. vivax malaria, patients with G6PD deficiency were excluded and enrolled into a separate 12-month observational study. They were treated with a weekly dose of 0.75 mg/kg primaquine for 8 weeks (PQ8W) plus dihydroartemisinin piperaquine (Indonesia) or chloroquine (Afghanistan, Ethiopia, Vietnam). G6PD status was diagnosed using the fluorescent spot test and confirmed by genotyping for locally prevalent G6PD variants. The risk of P. vivax recurrence following PQ8W and the consequent haematological recovery were characterized in all patients and in patients with genotypically confirmed G6PD variants, and compared with the patients enrolled in the main randomised control trial. Results Between July 2014 and November 2017, 42 male and 8 female patients were enrolled in Afghanistan (6), Ethiopia (5), Indonesia (19), and Vietnam (20). G6PD deficiency was confirmed by genotyping in 31 patients: Viangchan (14), Mediterranean (4), 357A-G (3), Canton (2), Kaiping (2), and one each for A-, Chatham, Gaohe, Ludhiana, Orissa, and Vanua Lava. Two patients had recurrent P. vivax parasitaemia (days 68 and 207). The overall 12-month cumulative risk of recurrent P. vivax malaria was 5.1% (95% CI: 1.3-18.9) and the incidence rate of recurrence was 46.8 per 1000 person-years (95% CI: 11.7-187.1). The risk of P. vivax recurrence was lower in G6PD deficient patients treated with PQ8W compared to G6PD normal patients in all treatment arms of the randomised controlled trial. Two of the 26 confirmed hemizygous males had a significant fall in haemoglobin (>5g/dl) after the first dose but were able to complete their 8 week regimen. Conclusions PQ8W was highly effective in ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles PLOS Neglected Tropical Diseases 17 9 e0011522 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Walter R J Taylor Niamh Meagher Benedikt Ley Kamala Thriemer Germana Bancone Ari Satyagraha Ashenafi Assefa Krisin Chand Nguyen Hoang Chau Mehul Dhorda Tamiru S Degaga Lenny L Ekawati Asrat Hailu Mohammad Anwar Hasanzai Mohammad Nader Naddim Ayodhia Pitaloka Pasaribu Awab Ghulam Rahim Inge Sutanto Ngo Viet Thanh Nguyen Thi Tuyet-Trinh Naomi Waithira Adugna Woyessa Arjen Dondorp Lorenz von Seidlein Julie A Simpson Nicholas J White J Kevin Baird Nicholas P Day Ric N Price Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background The World Health Organization recommends that primaquine should be given once weekly for 8-weeks to patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase (G6PD) deficiency, but data on its antirelapse efficacy and safety are limited. Methods Within the context of a multicentre, randomised clinical trial of two primaquine regimens in P. vivax malaria, patients with G6PD deficiency were excluded and enrolled into a separate 12-month observational study. They were treated with a weekly dose of 0.75 mg/kg primaquine for 8 weeks (PQ8W) plus dihydroartemisinin piperaquine (Indonesia) or chloroquine (Afghanistan, Ethiopia, Vietnam). G6PD status was diagnosed using the fluorescent spot test and confirmed by genotyping for locally prevalent G6PD variants. The risk of P. vivax recurrence following PQ8W and the consequent haematological recovery were characterized in all patients and in patients with genotypically confirmed G6PD variants, and compared with the patients enrolled in the main randomised control trial. Results Between July 2014 and November 2017, 42 male and 8 female patients were enrolled in Afghanistan (6), Ethiopia (5), Indonesia (19), and Vietnam (20). G6PD deficiency was confirmed by genotyping in 31 patients: Viangchan (14), Mediterranean (4), 357A-G (3), Canton (2), Kaiping (2), and one each for A-, Chatham, Gaohe, Ludhiana, Orissa, and Vanua Lava. Two patients had recurrent P. vivax parasitaemia (days 68 and 207). The overall 12-month cumulative risk of recurrent P. vivax malaria was 5.1% (95% CI: 1.3-18.9) and the incidence rate of recurrence was 46.8 per 1000 person-years (95% CI: 11.7-187.1). The risk of P. vivax recurrence was lower in G6PD deficient patients treated with PQ8W compared to G6PD normal patients in all treatment arms of the randomised controlled trial. Two of the 26 confirmed hemizygous males had a significant fall in haemoglobin (>5g/dl) after the first dose but were able to complete their 8 week regimen. Conclusions PQ8W was highly effective in ... |
format |
Article in Journal/Newspaper |
author |
Walter R J Taylor Niamh Meagher Benedikt Ley Kamala Thriemer Germana Bancone Ari Satyagraha Ashenafi Assefa Krisin Chand Nguyen Hoang Chau Mehul Dhorda Tamiru S Degaga Lenny L Ekawati Asrat Hailu Mohammad Anwar Hasanzai Mohammad Nader Naddim Ayodhia Pitaloka Pasaribu Awab Ghulam Rahim Inge Sutanto Ngo Viet Thanh Nguyen Thi Tuyet-Trinh Naomi Waithira Adugna Woyessa Arjen Dondorp Lorenz von Seidlein Julie A Simpson Nicholas J White J Kevin Baird Nicholas P Day Ric N Price |
author_facet |
Walter R J Taylor Niamh Meagher Benedikt Ley Kamala Thriemer Germana Bancone Ari Satyagraha Ashenafi Assefa Krisin Chand Nguyen Hoang Chau Mehul Dhorda Tamiru S Degaga Lenny L Ekawati Asrat Hailu Mohammad Anwar Hasanzai Mohammad Nader Naddim Ayodhia Pitaloka Pasaribu Awab Ghulam Rahim Inge Sutanto Ngo Viet Thanh Nguyen Thi Tuyet-Trinh Naomi Waithira Adugna Woyessa Arjen Dondorp Lorenz von Seidlein Julie A Simpson Nicholas J White J Kevin Baird Nicholas P Day Ric N Price |
author_sort |
Walter R J Taylor |
title |
Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. |
title_short |
Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. |
title_full |
Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. |
title_fullStr |
Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. |
title_full_unstemmed |
Weekly primaquine for radical cure of patients with Plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. |
title_sort |
weekly primaquine for radical cure of patients with plasmodium vivax malaria and glucose-6-phosphate dehydrogenase deficiency. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2023 |
url |
https://doi.org/10.1371/journal.pntd.0011522 https://doaj.org/article/78102e14bb3e47dbbf049aebb8955204 |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 17, Iss 9, p e0011522 (2023) |
op_relation |
https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011522&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011522 https://doaj.org/article/78102e14bb3e47dbbf049aebb8955204 |
op_doi |
https://doi.org/10.1371/journal.pntd.0011522 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
17 |
container_issue |
9 |
container_start_page |
e0011522 |
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