Publication: A comparison of two short-course primaquine regimens for the treatment and radical cure of Plasmodium vivax malaria in Thailand
Issued Date
2010-04-01
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ISSN
00029637
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2-s2.0-77950938226
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.82, No.4 (2010), 542-547
Suggested Citation
Sasithon Pukrittayakamee, Mallika Imwong, Kesinee Chotivanich, Pratap Singhasivanon, Nicholas P J Day, Nicholas J. White A comparison of two short-course primaquine regimens for the treatment and radical cure of Plasmodium vivax malaria in Thailand. American Journal of Tropical Medicine and Hygiene. Vol.82, No.4 (2010), 542-547. doi:10.4269/ajtmh.2010.09-0428 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/29244
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Title
A comparison of two short-course primaquine regimens for the treatment and radical cure of Plasmodium vivax malaria in Thailand
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Abstract
Thai adult males (N = 85) with acute Plasmodium vivax malaria and normal glucose-6-phosphate dehydrogenase screening were randomized to receive 30 mg or 60 mg primaquine daily for 7 days (N = 43 and 42, respectively). The regimens were well tolerated and all patients recovered fully. Median fever clearance (47 hours; range 4 to 130 hours), mean ± SD parasite clearance times (87.7 ± 25.3 hours), gametocyte clearance, and adverse effects were similar in the 2 groups. Two patients, 1 from each group, had a 30% reduction in hematocrit. The cumulative 28 day relapse rate (95% confidence interval) by Kaplan Meier survival analysis was 29% (16-49%) in the 30 mg group compared with 7% (2-24%) in the 60 mg group; P = 0.027. Comparison with previous data obtained at this same site suggests that the recurrences comprised approximately 17% recrudescences and 12% relapses in the 30 mg/day group compared with 3% recrudescences and 4% relapses in the 60 mg/day group. These data suggest that the dose-response relationships for primaquine's asexual stage and hypnozoitocidal activities in-vivo are different. A 1 week course of primaquine 60 mg daily is an effective treatment of vivax malaria in this region. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.