A Randomised Trial of an Eight-Week, Once Weekly Primaquine Regimen to Prevent Relapse of Plasmodium vivax in Northwest Frontier Province, Pakistan
2008

Effectiveness of an 8-Week Primaquine Regimen for Plasmodium vivax Malaria

Sample size: 200 publication 10 minutes Evidence: high

Author Information

Author(s): Leslie Toby, Mayan Ismail, Mohammed Nasir, Erasmus Panna, Kolaczinski Jan, Whitty Christopher J. M., Rowland Mark

Primary Institution: London School of Hygiene and Tropical Medicine

Hypothesis

Is an 8-week, once weekly primaquine regimen effective at preventing relapse of Plasmodium vivax malaria without the need for G6PD testing?

Conclusion

The 8-week primaquine regimen is more effective at preventing relapse of vivax malaria than the current standard treatment with chloroquine alone.

Supporting Evidence

  • There were 22 treatment failures in the placebo group compared to only 1 in the 14-day PQ group and 4 in the 8-week PQ group.
  • The 8-week PQ regimen showed a significantly lower failure rate compared to placebo.
  • Only one G6PD deficient patient was identified during the trial, and no serious adverse events were reported.

Takeaway

This study shows that taking a special medicine called primaquine once a week for 8 weeks can help stop people from getting sick again from a type of malaria called vivax.

Methodology

200 patients with confirmed Plasmodium vivax were randomly assigned to receive either an 8-week primaquine regimen, a placebo, or a 14-day primaquine regimen, all alongside standard chloroquine treatment.

Limitations

The study was not powered to show equivalence between the 14-day and 8-week PQ arms.

Participant Demographics

Patients were primarily Afghan refugees aged 3 years and older, with a median age of 10 years.

Statistical Information

P-Value

p<0.001

Confidence Interval

95%CI: 0.01-0.2

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pone.0002861

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