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A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand

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 cl...

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Autores principales: Pukrittayakamee, Sasithon, Imwong, Mallika, Chotivanich, Kesinee, Singhasivanon, Pratap, Day, Nicholas P. J., White, Nicholas J.
Formato: Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844579/
https://www.ncbi.nlm.nih.gov/pubmed/20348496
http://dx.doi.org/10.4269/ajtmh.2010.09-0428
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author Pukrittayakamee, Sasithon
Imwong, Mallika
Chotivanich, Kesinee
Singhasivanon, Pratap
Day, Nicholas P. J.
White, Nicholas J.
author_facet Pukrittayakamee, Sasithon
Imwong, Mallika
Chotivanich, Kesinee
Singhasivanon, Pratap
Day, Nicholas P. J.
White, Nicholas J.
author_sort Pukrittayakamee, Sasithon
collection PubMed
description 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.
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spelling pubmed-28445792010-04-01 A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand Pukrittayakamee, Sasithon Imwong, Mallika Chotivanich, Kesinee Singhasivanon, Pratap Day, Nicholas P. J. White, Nicholas J. Am J Trop Med Hyg Articles 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. The American Society of Tropical Medicine and Hygiene 2010-04 /pmc/articles/PMC2844579/ /pubmed/20348496 http://dx.doi.org/10.4269/ajtmh.2010.09-0428 Text en ©The American Society of Tropical Medicine and Hygiene http://creativecommons.org/licenses/by/2.5/ This is an Open Access article distributed under the terms of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Articles
Pukrittayakamee, Sasithon
Imwong, Mallika
Chotivanich, Kesinee
Singhasivanon, Pratap
Day, Nicholas P. J.
White, Nicholas J.
A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand
title A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand
title_full A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand
title_fullStr A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand
title_full_unstemmed A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand
title_short A Comparison of Two Short-Course Primaquine Regimens for the Treatment and Radical Cure of Plasmodium vivax Malaria in Thailand
title_sort comparison of two short-course primaquine regimens for the treatment and radical cure of plasmodium vivax malaria in thailand
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844579/
https://www.ncbi.nlm.nih.gov/pubmed/20348496
http://dx.doi.org/10.4269/ajtmh.2010.09-0428
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