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dc.contributor.authorLek Dysoleyen_US
dc.contributor.authorSaorin Kimen_US
dc.contributor.authorSergio Lopesen_US
dc.contributor.authorNimol Khimen_US
dc.contributor.authorSteven Bjorgesen_US
dc.contributor.authorSamphornarann Topen_US
dc.contributor.authorChea Huchen_US
dc.contributor.authorHuy Rekolen_US
dc.contributor.authorNelli Westercampen_US
dc.contributor.authorMark M. Fukudaen_US
dc.contributor.authorJimee Hwangen_US
dc.contributor.authorArantxa Roca-Feltreren_US
dc.contributor.authorMavuto Mukakaen_US
dc.contributor.authorDidier Menarden_US
dc.contributor.authorWalter R. Tayloren_US
dc.contributor.otherInstitut Pasteur du Cambodgeen_US
dc.contributor.otherCenters for Disease Control and Preventionen_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherNuffield Department of Clinical Medicineen_US
dc.contributor.otherInstitut Pasteur, Parisen_US
dc.contributor.otherMalaria Consortiumen_US
dc.contributor.otherCambodia Country Officeen_US
dc.contributor.otherNational Institute of Public Healthen_US
dc.contributor.otherNational Centre for Parasitology, Entomology and Malaria Controlen_US
dc.date.accessioned2020-01-27T10:00:39Z-
dc.date.available2020-01-27T10:00:39Z-
dc.date.issued2019-03-12en_US
dc.identifier.citationBMC Infectious Diseases. Vol.19, No.1 (2019)en_US
dc.identifier.issn14712334en_US
dc.identifier.other2-s2.0-85063011999en_US
dc.identifier.urihttp://repository.li.mahidol.ac.th/dspace/handle/123456789/51792-
dc.description.abstract© 2019 The Author(s). Background: The WHO recommends single low-dose primaquine (SLDPQ, 0.25 mg/kg body weight) in falciparum-infected patients to block malaria transmission and contribute to eliminating multidrug resistant Plasmodium falciparum from the Greater Mekong Sub region (GMS). However, the anxiety regarding PQ-induced acute haemolytic anaemia in glucose-6-phosphate dehydrogenase deficiency (G6PDd) has hindered its use. Therefore, we assessed the tolerability of SLDPQ in Cambodia to inform national policy. Methods: This open randomised trial of dihydroartemisinin-piperaquine (DHAPP) + SLDPQ vs. DHAPP alone recruited Cambodians aged ≥1 year with acute uncomplicated P. falciparum. Randomisation was 4:1 DHAPP+SLDPQ: DHAPP for G6PDd patients and 1:1 for G6PDn patients, according to the results of the qualitative fluorescent spot test. Definitive G6PD status was determined by genotyping. Day (D) 7 haemoglobin (Hb) concentration was the primary outcome measure. Results: One hundred nine patients (88 males, 21 females), aged 4-76 years (median 23) were enrolled; 12 were G6PDd Viangchan (9 hemizygous males, 3 heterozygous females). Mean nadir Hb occurred on D7 [11.6 (range 6.4 15.6) g/dL] and was significantly lower (p = 0.040) in G6PDd (n = 9) vs. G6PDn (n = 46) DHAPP+SLDPQ recipients: 10.9 vs. 12.05 g/dL, Δ = -1.15 (95% CI: -2.24 -0.05) g/dL. Three G6PDn patients had D7 Hb concentrations < 8 g/dL; D7-D0 Hbs were 6.4 6.9, 7.4 7.4, and 7.5 8.2 g/dL. For all patients, mean (range) D7-D0 Hb decline was -1.45 (-4.8 2.4) g/dL, associated significantly with higher D0 Hb, higher D0 parasitaemia, and receiving DHAPP; G6PDd was not a factor. No patient required a blood transfusion. Conclusions: DHAPP+SLDPQ was associated with modest Hb declines in G6PD Viangchan, a moderately severe variant. Our data augment growing evidence that SLDPQ in SE Asia is well tolerated and appears safe in G6PDd patients. Cambodia is now deploying SLDPQ and this should encourage other GMS countries to follow suit.en_US
dc.rightsMahidol Universityen_US
dc.source.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85063011999&origin=inwarden_US
dc.subjectMedicineen_US
dc.titleThe tolerability of single low dose primaquine in glucose-6-phosphate deficient and normal falciparum-infected Cambodiansen_US
dc.typeArticleen_US
dc.rights.holderSCOPUSen_US
dc.identifier.doi10.1186/s12879-019-3862-1en_US
dc.identifier.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85063011999&origin=inwarden_US
Appears in Collections:Scopus 2019

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