The quality of evidence is downgraded by imprecise results.
A Cochrane review [Abstract] 1 included 8 randomized controlled trials (RCTs) of adults and children with P. vivax malaria using any regimen of either chloroquine or an artemisinin-based combination therapy (ACT) plus primaquine with either higher daily doses for 14 days, shorter regimens with the same total dose, or using weekly dosing regimens; compared with the usual standard regimens recommended by the WHO (0.25 or 0.5 mg/kg/day for 14 days), or a comparison of these two WHO-recommended regimens.
The analysis did not detect a difference in recurrence between the 7-day regimen and the standard 14-day regimen of 0.5 mg/kg/day primaquine, and no serious adverse events were reported in G6PD-normal participants taking 0.5 mg/kg/day of primaquine.
Long primaquine treatment course can be difficult to complete, because primaquine can cause dangerous haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, meaning that physicians may be reluctant to prescribe in areas where G6PD testing is not available. The shorter regimen may be useful in G6PD-normal patients if there are treatment adherence concerns.
Abstract and full text in Cochrane database http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012656.pub2/full (licence for full text required)
Date of latest search: 17 December 2018
Primary/Secondary Keywords