title: Primaquine for prevention of malaria in travelers.
abstract: An expanding risk and range of endemic malaria threatens travelers. Primaquine is an old drug recently demonstrated to offer effective prophylaxis. Clinical trials conducted in Indonesia, Kenya, and Colombia showed that a primaquine base (30 mg per day) had protective efficacy against Plasmodium falciparum and Plasmodium vivax of 85%-93%. Among 339 children (age, >8 years) and adults taking this regimen for 12-52 weeks, there was no greater risk of adverse symptomatic events among primaquine users than among recipients of placebo in double-blind studies. Among 151 subjects evaluated after 20 or 52 weeks of daily primaquine therapy, methemoglobinemia was found to be mild (<13%; typically <6%) and transient (duration, <2 weeks). We consider primaquine base (0.5 mg/kg per day consumed with food) to be safe, well-tolerated, and effective prophylaxis against malaria for nonpregnant persons and those with normal glucose-6-phosphate dehydrogenase levels. Primaquine's major advantage over most drugs for chemoprophylaxis is that it does not have to be taken before entering or beyond 3 days after leaving a malarious area.
authors.affiliation: US Naval Medical Research Center Detachment, Lima, Peru. baird@nmrcd.med.navy.mil
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Baird
authors.forename: David J
authors.initials: DJ
authors.lastname: Fryauff
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D018890:Chemoprevention; D002986:Clinical Trials as Topic; D004361:Drug Tolerance; D006801:Humans; D016778:Malaria, Falciparum / Q000517:prevention & control*; D016780:Malaria, Vivax / Q000517:prevention & control*; D010963:Plasmodium falciparum / Q000187:drug effects; D010966:Plasmodium vivax / Q000187:drug effects; D011319:Primaquine / Q000009:adverse effects / Q000627:therapeutic use*; D014195:Travel
chemical_list: D000962:Antimalarials; D011319:Primaquine