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.Mahidol University2023-06-182023-06-182022-04-01Journal of Infectious Diseases Vol.225 No.7 (2022) , 1215-122600221899https://repository.li.mahidol.ac.th/handle/123456789/85983Background: 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.MedicineArticleSCOPUS10.1093/infdis/jiaa4982-s2.0-851281614811537661332778875