Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis
Issued Date
2022-04-01
Resource Type
ISSN
00221899
eISSN
15376613
Scopus ID
2-s2.0-85128161481
Pubmed ID
32778875
Journal Title
Journal of Infectious Diseases
Volume
225
Issue
7
Start Page
1215
End Page
1226
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Infectious Diseases Vol.225 No.7 (2022) , 1215-1226
Suggested Citation
Stepniewska K., Humphreys G.S., Gonçalves B.P., Craig E., Gosling R., Guerin P.J., Price R.N., Barnes K.I., Raman J., Smit M.R., D'Alessandro U., Stone W.J.R., Bjorkman A., Samuels A.M., Arroyo-Arroyo M.I., Bastiaens G.J.H., Brown J.M., Dicko A., El-Sayed B.B., Elzaki S.E.G., Eziefula A.C., Kariuki S., Kwambai T.K., Maestre A.E., Martensson A., Mosha D., Mwaiswelo R.O., Ngasala B.E., Okebe J., Roh M.E., Sawa P., Tiono A.B., Chen I., Drakeley C.J., Bousema T. Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis. Journal of Infectious Diseases Vol.225 No.7 (2022) , 1215-1226. 1226. doi:10.1093/infdis/jiaa498 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85983
Title
Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis
Author(s)
Stepniewska K.
Humphreys G.S.
Gonçalves B.P.
Craig E.
Gosling R.
Guerin P.J.
Price R.N.
Barnes K.I.
Raman J.
Smit M.R.
D'Alessandro U.
Stone W.J.R.
Bjorkman A.
Samuels A.M.
Arroyo-Arroyo M.I.
Bastiaens G.J.H.
Brown J.M.
Dicko A.
El-Sayed B.B.
Elzaki S.E.G.
Eziefula A.C.
Kariuki S.
Kwambai T.K.
Maestre A.E.
Martensson A.
Mosha D.
Mwaiswelo R.O.
Ngasala B.E.
Okebe J.
Roh M.E.
Sawa P.
Tiono A.B.
Chen I.
Drakeley C.J.
Bousema T.
Humphreys G.S.
Gonçalves B.P.
Craig E.
Gosling R.
Guerin P.J.
Price R.N.
Barnes K.I.
Raman J.
Smit M.R.
D'Alessandro U.
Stone W.J.R.
Bjorkman A.
Samuels A.M.
Arroyo-Arroyo M.I.
Bastiaens G.J.H.
Brown J.M.
Dicko A.
El-Sayed B.B.
Elzaki S.E.G.
Eziefula A.C.
Kariuki S.
Kwambai T.K.
Maestre A.E.
Martensson A.
Mosha D.
Mwaiswelo R.O.
Ngasala B.E.
Okebe J.
Roh M.E.
Sawa P.
Tiono A.B.
Chen I.
Drakeley C.J.
Bousema T.
Author's Affiliation
Infectious Diseases Data Observatory
WorldWide Antimalarial Resistance Network
Centre National de Recherche et de Formation sur le Paludisme
Faculty of Tropical Medicine, Mahidol University
Brighton and Sussex Medical School
Muhimbili University of Health and Allied Sciences
University of the Witwatersrand Faculty of Health Sciences
University of Bamako Faculty of Medicine, Pharmacy and Odonto-Stomatology
Tropical Medicine Research Institute Sudan
Ifakara Health Institute
Kenya Medical Research Institute
Universidad de Antioquia
International Centre of Insect Physiology and Ecology Nairobi
National Institute for Communicable Diseases
London School of Hygiene & Tropical Medicine
Green Templeton College
Menzies School of Health Research
University of California, San Francisco
Centers for Disease Control and Prevention
Churchill Hospital
Liverpool School of Tropical Medicine
Rijnstate Hospital
Karolinska Institutet
Uppsala Universitet
Radboud University Medical Center
University of Cape Town
Dar es Salaam City Council
WorldWide Antimalarial Resistance Network
Centre National de Recherche et de Formation sur le Paludisme
Faculty of Tropical Medicine, Mahidol University
Brighton and Sussex Medical School
Muhimbili University of Health and Allied Sciences
University of the Witwatersrand Faculty of Health Sciences
University of Bamako Faculty of Medicine, Pharmacy and Odonto-Stomatology
Tropical Medicine Research Institute Sudan
Ifakara Health Institute
Kenya Medical Research Institute
Universidad de Antioquia
International Centre of Insect Physiology and Ecology Nairobi
National Institute for Communicable Diseases
London School of Hygiene & Tropical Medicine
Green Templeton College
Menzies School of Health Research
University of California, San Francisco
Centers for Disease Control and Prevention
Churchill Hospital
Liverpool School of Tropical Medicine
Rijnstate Hospital
Karolinska Institutet
Uppsala Universitet
Radboud University Medical Center
University of Cape Town
Dar es Salaam City Council
Other Contributor(s)
Abstract
Background: Since the World Health Organization recommended single low-dose (0.25 mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant Plasmodium falciparum, several single-site studies have been conducted to assess efficacy. Methods: An individual patient meta-Analysis to assess gametocytocidal and transmission-blocking efficacy of PQ in combination with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (1) gametocyte carriage in the first 2 weeks post treatment; and (2) the probability of infecting at least 1 mosquito or of a mosquito becoming infected. Results: In 2574 participants from 14 studies, PQ reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytemia on day 0 (odds ratio [OR],0.22; 95% confidence interval [CI],. 17-.28 and OR,0.12; 95% CI,. 08-.16, respectively). Rate of decline in gametocyte carriage was faster when PQ was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (P=.010 for day 7). Addition of 0.25 mg/kg PQ was associated with near complete prevention of transmission to mosquitoes. Conclusions: Transmission blocking is achieved with 0.25 mg/kg PQ. Gametocyte persistence and infectivity are lower when PQ is combined with AL compared to DP.