Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine
Abstract Background Primaquine is an important gametocytocidal drug that is combined with conventional malaria treatment for prevention of Plasmodium falciparum malaria transmission. Primaquine has been administered together on the first or the last day of conventional treatment but the impact of pr...
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ftdoajarticles:oai:doaj.org/article:8684faa6ae204967b3287eab3d8b8e1d 2023-05-15T15:19:06+02:00 Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine Seif Shekalaghe Dominic Mosha Ali Hamad Thabit A. Mbaga Michael Mihayo Teun Bousema Chris Drakeley Salim Abdulla 2020-01-01T00:00:00Z https://doi.org/10.1186/s12936-020-3121-3 https://doaj.org/article/8684faa6ae204967b3287eab3d8b8e1d EN eng BMC https://doi.org/10.1186/s12936-020-3121-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-3121-3 1475-2875 https://doaj.org/article/8684faa6ae204967b3287eab3d8b8e1d Malaria Journal, Vol 19, Iss 1, Pp 1-9 (2020) Malaria Transmission Gametocyte Primaquine Artemether–lumefantrine Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2020 ftdoajarticles https://doi.org/10.1186/s12936-020-3121-3 2022-12-31T09:15:57Z Abstract Background Primaquine is an important gametocytocidal drug that is combined with conventional malaria treatment for prevention of Plasmodium falciparum malaria transmission. Primaquine has been administered together on the first or the last day of conventional treatment but the impact of primaquine timing has never been examined. This study aimed to assess safety, efficacy and optimal timing of single full-dose (0.75 mg/kg) primaquine when added to a standard 6-dose regimen of artemether–lumefantrine (AL). Methods In an individual-level randomized controlled trial, enrolled participants who were G6PD normal and had uncomplicated P. falciparum malaria were randomly assigned to receive: AL only; AL and a single 0.75 mg/kg primaquine dose on the first day of AL (day 1); or AL and single 0.75 mg//kg primaquine on the last day of AL (day 3). On days 2, 3, 4, 8, 11 and 15, gametocytes were assessed and quantified by microscope and quantitative nuclear acid sequence based quantification (QT-NASBA). Results Overall, 111 participants aged between 3 and 17 years were randomly allocated to receive AL only (36) or combined with primaquine on day 1 (38), or primaquine on day 3 (37). Day 4 gametocyte prevalence in AL + day 1 primaquine was half the level seen in either AL + day 3 primaquine or AL only arm (11% [4/35] vs 26% [8/31] and 27% [8/30], respectively) albeit not statistically significant. A similar trend of lower gametocyte in the AL + day 1 primaquine verses AL + day 3 primaquine or AL only arm was observed in mean gametocyte density. Mean (sd) haemoglobin level in AL + day 3 primaquine arm recovered from -0.42(1.2) g/dl on day 2 to 0.35 (1.5) g/dl on day 15 of follow up. This was not the case in AL only and AL + day 1 primaquine arms during the same follow-up period, although the difference was not statistically significant (p = 318). No serious adverse events reported in the study. Across arms, 23% (26/111) of participants reported a total of 31 mild adverse events and the difference was not statistically ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 19 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Malaria Transmission Gametocyte Primaquine Artemether–lumefantrine Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Malaria Transmission Gametocyte Primaquine Artemether–lumefantrine Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Seif Shekalaghe Dominic Mosha Ali Hamad Thabit A. Mbaga Michael Mihayo Teun Bousema Chris Drakeley Salim Abdulla Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine |
topic_facet |
Malaria Transmission Gametocyte Primaquine Artemether–lumefantrine Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Primaquine is an important gametocytocidal drug that is combined with conventional malaria treatment for prevention of Plasmodium falciparum malaria transmission. Primaquine has been administered together on the first or the last day of conventional treatment but the impact of primaquine timing has never been examined. This study aimed to assess safety, efficacy and optimal timing of single full-dose (0.75 mg/kg) primaquine when added to a standard 6-dose regimen of artemether–lumefantrine (AL). Methods In an individual-level randomized controlled trial, enrolled participants who were G6PD normal and had uncomplicated P. falciparum malaria were randomly assigned to receive: AL only; AL and a single 0.75 mg/kg primaquine dose on the first day of AL (day 1); or AL and single 0.75 mg//kg primaquine on the last day of AL (day 3). On days 2, 3, 4, 8, 11 and 15, gametocytes were assessed and quantified by microscope and quantitative nuclear acid sequence based quantification (QT-NASBA). Results Overall, 111 participants aged between 3 and 17 years were randomly allocated to receive AL only (36) or combined with primaquine on day 1 (38), or primaquine on day 3 (37). Day 4 gametocyte prevalence in AL + day 1 primaquine was half the level seen in either AL + day 3 primaquine or AL only arm (11% [4/35] vs 26% [8/31] and 27% [8/30], respectively) albeit not statistically significant. A similar trend of lower gametocyte in the AL + day 1 primaquine verses AL + day 3 primaquine or AL only arm was observed in mean gametocyte density. Mean (sd) haemoglobin level in AL + day 3 primaquine arm recovered from -0.42(1.2) g/dl on day 2 to 0.35 (1.5) g/dl on day 15 of follow up. This was not the case in AL only and AL + day 1 primaquine arms during the same follow-up period, although the difference was not statistically significant (p = 318). No serious adverse events reported in the study. Across arms, 23% (26/111) of participants reported a total of 31 mild adverse events and the difference was not statistically ... |
format |
Article in Journal/Newspaper |
author |
Seif Shekalaghe Dominic Mosha Ali Hamad Thabit A. Mbaga Michael Mihayo Teun Bousema Chris Drakeley Salim Abdulla |
author_facet |
Seif Shekalaghe Dominic Mosha Ali Hamad Thabit A. Mbaga Michael Mihayo Teun Bousema Chris Drakeley Salim Abdulla |
author_sort |
Seif Shekalaghe |
title |
Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine |
title_short |
Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine |
title_full |
Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine |
title_fullStr |
Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine |
title_full_unstemmed |
Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine |
title_sort |
optimal timing of primaquine to reduce plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine |
publisher |
BMC |
publishDate |
2020 |
url |
https://doi.org/10.1186/s12936-020-3121-3 https://doaj.org/article/8684faa6ae204967b3287eab3d8b8e1d |
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Arctic |
geographic_facet |
Arctic |
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Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 19, Iss 1, Pp 1-9 (2020) |
op_relation |
https://doi.org/10.1186/s12936-020-3121-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-3121-3 1475-2875 https://doaj.org/article/8684faa6ae204967b3287eab3d8b8e1d |
op_doi |
https://doi.org/10.1186/s12936-020-3121-3 |
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Malaria Journal |
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19 |
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1766349294840840192 |