title: Rationale for recommending a lower dose of primaquine as a Plasmodium falciparum gametocytocide in populations where G6PD deficiency is common.
abstract: In areas of low malaria transmission, it is currently recommended that a single dose of primaquine (0.75 mg base/kg; 45 mg adult dose) be added to artemisinin combination treatment (ACT) in acute falciparum malaria to block malaria transmission. Review of studies of transmission-blocking activity based on the infectivity of patients or volunteers to anopheline mosquitoes, and of haemolytic toxicity in glucose 6-dehydrogenase (G6PD) deficient subjects, suggests that a lower primaquine dose (0.25 mg base/kg) would be safer and equally effective. This lower dose could be deployed together with ACTs without G6PD testing wherever use of a specific gametocytocide is indicated.
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. nickw@tropmedres.ac
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: White
authors.forename: Li Guo
authors.initials: LG
authors.lastname: Qiao
authors.forename: Gao
authors.initials: G
authors.lastname: Qi
authors.forename: Lucio
authors.initials: L
authors.lastname: Luzzatto
mesh_terms: D000328:Adult; D000743:Anemia, Hemolytic / Q000139:chemically induced / Q000201:enzymology / Q000235:genetics; D000818:Animals; D000852:Anopheles / Q000469:parasitology / Q000472:pathogenicity; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D037621:Artemisinins / Q000008:administration & dosage / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005954:Glucosephosphate Dehydrogenase / Q000235:genetics; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications* / Q000201:enzymology / Q000235:genetics; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology / Q000472:pathogenicity; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy* / Q000635:transmission; D008297:Male; D018512:Parasitemia / Q000150:complications / Q000188:drug therapy; D010963:Plasmodium falciparum / Q000187:drug effects; D011319:Primaquine / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin; D005954:Glucosephosphate Dehydrogenase; D011319:Primaquine