Nutritional Advice El Mondo
Objectives:
Since the World Health Organization recommended single low-dose (0.25mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant P. falciparum, several single-site studies have been conducted to assess its efficacy. Therefore, this review article has been conducted.
What is the efficacy of primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant P. falciparum?
Study design:
This review article included 14 studies with 2,574 participants.
Results and conclusions:
The investigators found primaquine significantly reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytaemia on day 0 [OR = 0.22, 95% CI = 0.17 to 0.28 and OR = 0.12, 95% CI = 0.08 to 0.16, respectively].
The investigators found the rate of decline in gametocyte carriage was faster when primaquine was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) [p = 0.010 for day 7].
Addition of 0.25mg/kg primaquine was associated with near complete prevention of transmission to mosquitoes.
The investigators concluded primaquine's transmission-blocking effects are achieved with 0.25 mg/kg primaquine. Gametocyte persistence and infectivity are lower when primaquine is combined with artemether-lumefantrine compared to dihydroartemisinin-piperaquine.
Original title:
Efficacy of single dose primaquine with artemisinin combination therapy on P. falciparum gametocytes and transmission: A WWARN individual patient meta-analysis by Stepniewska K, Humphreys GS, […], Bousema T.
Link:
https://pubmed.ncbi.nlm.nih.gov/32778875/
Additional information of El Mondo:
Find more information/studies on malaria and malnutrition right here.