Prevention of Plasmodium vivax malaria recurrence: efficacy of the standard total dose of primaquine administered over 3 days.
BACKGROUND
The standard total dose (STD) of primaquine to prevent Plasmodium vivax recurrence is 0.25mg/kg day administered over 14 days (STD-14). We evaluated, in an endemic zone of Colombia, the anti-recurrence efficacy of the STD dose administered over 3 and 14 days, and of sub-STD dose administered over 3 days (71%STD-3, 50%STD-3).


METHODS
A controlled clinical trial was carried out with 188 subjects allocated into one of four treatment groups: STD-14, STD-3, 71%STD-3, 50%STD-3.


RESULTS
Recurrences during the 120 days of follow-up were 15% in STD-14, and 57% in STD-3. Treatment with 71%STD-3 and 50%STD-3 resulted in recurrence in >48% subjects within 120 days after the primary episode. High daily doses (1.17 mg/kg day) were well tolerated.


CONCLUSIONS
(a) The standard dose and regimen (STD-14) of primaquine to prevent P. vivax relapse is recommended. The administration of the same dose over 3 days (STD-3) should be avoided; (b) doses lower than the STD doses administered over 3 days are ineffective in preventing relapse.
Carmona-Fonseca
Jaime
J
Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Maestre
Amanda
A
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D018890:Chemoprevention / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003105:Colombia; D005260:Female; D006801:Humans; D007223:Infant; D016780:Malaria, Vivax / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011319:Primaquine / Q000008:administration & dosage / Q000627:therapeutic use*; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
D000962:Antimalarials; D011319:Primaquine