Publication: The reality of using primaquine
Accepted Date
2010-12-27
Issued Date
2010
Copyright Date
2010
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Language
eng
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Mahidol University
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BioMed Central
Bibliographic Citation
Burgoine KL, Bancone G, Nosten F. The reality of using primaquine. Malar J. 2010 Dec 27;9:376.
Suggested Citation
Burgoine, Kathy L., Bancone, Germana, Nosten, François The reality of using primaquine. Burgoine KL, Bancone G, Nosten F. The reality of using primaquine. Malar J. 2010 Dec 27;9:376.. doi:10.1186/1475-2875-9-376 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/720
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Title
The reality of using primaquine
Corresponding Author(s)
Abstract
BACKGROUND: Primaquine is currently the only medication used for radical cure of
Plasmodium vivax infection. Unfortunately, its use is not without risk. Patients
with glucose-6-phosphate dehydrogenase (G6PD) deficiency have an increased
susceptibility to haemolysis when given primaquine. This potentially fatal
clinical syndrome can be avoided if patients are tested for G6PD deficiency and
adequately informed before being treated.
CASE PRESENTATION: A 35-year old male presented to our clinic on the Thai-Burmese
border with a history and clinical examination consistent with intravascular
haemolysis. The patient had been prescribed primaquine and chloroquine four days
earlier for a P. vivax infection. The medication instructions had not been given
in a language understood by the patient and he had not been tested for G6PD
deficiency. The patient was not only G6PD deficient but misunderstood the
instructions and took all his primaquine tablets together. With appropriate
treatment the patient recovered and was discharged home a week later.
CONCLUSIONS: Whilst primaquine remains the drug of choice to eradicate
hypnozoites and control P. vivax transmission, the risks associated with its use
must be minimized during its deployment. In areas where P. vivax exists, patients
should be tested for G6PD deficiency and adequately informed before
administration of primaquine.