Publication: Management of relapsing Plasmodium vivax malaria
Issued Date
2016-10-02
Resource Type
ISSN
17448336
14787210
14787210
Other identifier(s)
2-s2.0-84987724376
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Expert Review of Anti-Infective Therapy. Vol.14, No.10 (2016), 885-900
Suggested Citation
Cindy S. Chu, Nicholas J. White Management of relapsing Plasmodium vivax malaria. Expert Review of Anti-Infective Therapy. Vol.14, No.10 (2016), 885-900. doi:10.1080/14787210.2016.1220304 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/40733
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Management of relapsing Plasmodium vivax malaria
Author(s)
Other Contributor(s)
Abstract
© 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Introduction: Relapses are important contributors to illness and morbidity in Plasmodium vivax and P. ovale infections. Relapse prevention (radical cure) with primaquine is required for optimal management, control and ultimately elimination of Plasmodium vivax malaria. A review was conducted with publications in English, French, Portuguese and Spanish using the search terms ‘P. vivax’ and ‘relapse’. Areas covered: Hypnozoites causing relapses may be activated weeks or months after initial infection. Incidence and temporal patterns of relapse varies geographically. Relapses derive from parasites either genetically similar or different from the primary infection indicating that some derive from previous infections. Malaria illness itself may activate relapse. Primaquine is the only widely available treatment for radical cure. However, it is often not given because of uncertainty over the risks of primaquine induced haemolysis when G6PD deficiency testing is unavailable. Recommended dosing of primaquine for radical cure in East Asia and Oceania is 0.5 mg base/kg/day and elsewhere is 0.25 mg base/kg/day. Alternative treatments are under investigation. Expert commentary: Geographic heterogeneity in relapse patterns and chloroquine susceptibility of P. vivax, and G6PD deficiency epidemiology mean that radical treatment should be given much more than it is today. G6PD testing should be made widely available so primaquine can be given more safely.