Efficacy of a 14-day primaquine regimen in preventing relapses in patients with Plasmodium vivax malaria in Mumbai, India.
We studied the antirelapse efficacy of a supervised 14-d 15 mg/d regimen of primaquine therapy (n = 131) compared with no antirelapse therapy (n = 142) in 273 patients with confirmed Plasmodium vivax malaria in Mumbai, India, between July 1998 and April 2000. There were 6/131 (4.6%) recurrences in patients given primaquine compared with 13/142 (9.2%) in those not given antirelapse therapy. In the 14-d primaquine group, polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) genotyping analysis of pre- and post-treatment blood samples was done for the 6 patients who had a recurrence of parasitaemia and the results gave a true relapse rate of 2.29% (3/131), 2 samples were classified as reinfections and 1 sample did not amplify. Our results indicate probable resistance to the 14-d regimen of primaquine for the first time in India and illustrate the need to (i) monitor patients given this regimen and (ii) carry out comparative studies between primaquine and new drugs such as tafenoquine and bulaquine for preventing relapses.
Rajgor
D D
DD
Department of Clinical Pharmacology, Seth GS Medical College & KEM Hospital, Parel, Mumbai 400 012, India.
Gogtay
N J
NJ
Kadam
V S
VS
Kamtekar
K D
KD
Dalvi
S S
SS
Chogle
A R
AR
Aigal
U
U
Bichile
L S
LS
Kain
K C
KC
Kshirsagar
N A
NA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016780:Malaria, Vivax / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000517:prevention & control; D010966:Plasmodium vivax / Q000187:drug effects; D016133:Polymerase Chain Reaction / Q000379:methods; D018807:Polymorphism, Single-Stranded Conformational; D011319:Primaquine / Q000627:therapeutic use*; D012008:Recurrence; D016037:Single-Blind Method; D016896:Treatment Outcome
D000962:Antimalarials; D011319:Primaquine