[Plasmodium vivax: therapy update].
IMPACT OF PLASMODIUM VIVAX WORLDWIDE: Plasmodium vivax is the most widespread malanal agent in the world. Unlike Plasmodium falciparum, P. vivax can cause early or late recurrence and is not fatal (benign tertian malaria). EMERGENCE OF RESISTANT STRAINS: P. vivax strains resistant to chloroquine, then primaquine, have emerged over the last decade, creating the need for a new therapeutic strategy. TREATMENT OF PRIMARY DISEASE: Generally, chloroquine is the first intention treatment, excepting patients who also have P. falciparum infection or a strain with suspected resistance to chloroquine. Mefloquine, quinine and halofantrine are also logical alternatives. TREATMENT OF RECURRENT DISEASE: A schizonticidal agent should be given followed by a hypnozoitocidal agent, primaquine. Primaquine dosage should now be raised or adjusted to the patient's weight.
Tafenoquine, delayed-release amino-8-quinoleine, is a potential alternative for primaquine for the treatment of recurrences. Studies are also in progress to evaluate the role of primaquine as a prophylaxic agent.
Nicolas
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X
Service de Médecine interne, HIA Clermont-tonnerre, F 29240 Brest Naval. xfnicolas@hotmail.com
Granier
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H
Laborde
J P
JP
Talarmin
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F
Klotz
F
F
D000818:Animals; D006801:Humans; D016780:Malaria, Vivax / Q000188:drug therapy*; D012008:Recurrence