Therapeutic Efficacy of Alternative Primaquine Regimens to Standard Treatment in Preventing Relapses by Plasmodium Vivax: A Systematic Review and Meta-analysis

Overview

Journal Colomb Med (Cali)

Specialties General Medicine
Public Health

Date 2016 Feb 6

PMID 26848199

Citations 2

Authors

Lina Marcela Zuluaga-Idarraga

Maria-Eulalia Tamayo Perez

Daniel Camilo Aguirre-Acevedo

Affiliations

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Abstract

Objective: To compare efficacy and safety of primaquine regimens currently used to prevent relapses by P. vivax.

Methods: A systematic review was carried out to identify clinical trials evaluating efficacy and safety to prevent malaria recurrences by P. vivax of primaquine regimen 0.5 mg/kg/ day for 7 or 14 days compared to standard regimen of 0.25 mg/kg/day for 14 days. Efficacy of primaquine according to cumulative incidence of recurrences after 28 days was determined. The overall relative risk with fixed-effects meta-analysis was estimated.

Results: For the regimen 0.5 mg/kg/day/7 days were identified 7 studies, which showed an incidence of recurrence between 0% and 20% with follow-up 60-210 days; only 4 studies comparing with the standard regimen 0.25 mg/kg/day/14 days and no difference in recurrences between both regimens (RR= 0.977, 95% CI= 0.670 to 1.423) were found. 3 clinical trials using regimen 0.5 mg/kg/day/14 days with an incidence of recurrences between 1.8% and 18.0% during 330-365 days were identified; only one study comparing with the standard regimen (RR= 0.846, 95% CI= 0.484 to 1.477). High risk of bias and differences in handling of included studies were found.

Conclusion: Available evidence is insufficient to determine whether currently PQ regimens used as alternative rather than standard treatment have better efficacy and safety in preventing relapse of P. vivax. Clinical trials are required to guide changes in treatment regimen of malaria vivax.

Citing Articles

Chloroquine-primaquine therapeutic response and safety in patients with uncomplicated Plasmodium vivax malaria in the Colombian Amazon region.

Calderon-Ruiz P, Velez-Tobon G, Bolivar-Hernandez S, Murcia-Montano L, Tobon-Castano A Malar J. 2024; 23(1):348.

PMID: 39558343 PMC: 11575219. DOI: 10.1186/s12936-024-05170-z.

Primaquine at alternative dosing schedules for preventing relapse in people with Plasmodium vivax malaria.

Milligan R, Daher A, Graves P Cochrane Database Syst Rev. 2019; 7:CD012656.

PMID: 31274189 PMC: 6611223. DOI: 10.1002/14651858.CD012656.pub2.

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