TY - JOUR
T1 - Therapeutic assessment of primaquine for radical cure of plasmodium vivax malaria at primary and tertiary care centres in Southwestern India
AU - Kumar, Rishikesh
AU - Guddattu, Vasudeva
AU - Saravu, Kavitha
N1 - Funding Information:
This work was supported by an extramural research grant (no. AMR/46/2011-ECD-I) and a Senior Research Fellowship Grant (no. 80/93/2015-ECD-I) from the Indian Council of Medical Research, New Delhi, India. The funding council had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors are immensely grateful to all the participants of this study. Much of the field work carried out by Mr. Satish Kitta Madivala and Mr. Prashantha Prabhu, Laboratory Assistants, is thankfully acknowledged.
Publisher Copyright:
© 2016, Korean Society for Parasitology and Tropical Medicine.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Acquaintance is scanty on primaquine (PQ) efficacy and Plasmodium vivax recurrence in Udupi district, Karnataka, India. We assessed the efficacy of 14 days PQ regimen (0.25 mg/kg/day) to prevent P. vivax recurrence. Microscopically, aparasitemic adults (≥18 years) after acute vivax malaria on day 28 were re-enrolled into 15 months’ long follow-up study. A peripheral blood smear examination was performed with participants at every 1-2 month interval. A nested PCR test was performed to confirm the mono-infection with P. vivax. Of 114 participants, 28 (24.6%) recurred subsequently. The median (IQR) duration of the first recurrence was 3.1 (2.2-5.8) months which ranged from 1.2 to 15.1 months, including initial 28 days. Participants with history of vivax malaria had significantly higher risk of recurrence, with hazard ratio (HR) (95% CI) of 2.62 (1.24-5.54) (P = 0.012). Severity of disease (11.4%, 13/114) was not associated (P = 1.00) with recurrence. Of 28 recurrence cases, the nPCR proved that P. vivax mono-infection recurrence rate was at least 72.7% (16/22) at first recurrence. In Udupi district, PQ dose of 0.25 mg/kg/day over 14 days seems inadequate to prevent recurrence in substantial proportion of vivax malaria. Patients with a history of vivax malaria are at high risk of recurrences.
AB - Acquaintance is scanty on primaquine (PQ) efficacy and Plasmodium vivax recurrence in Udupi district, Karnataka, India. We assessed the efficacy of 14 days PQ regimen (0.25 mg/kg/day) to prevent P. vivax recurrence. Microscopically, aparasitemic adults (≥18 years) after acute vivax malaria on day 28 were re-enrolled into 15 months’ long follow-up study. A peripheral blood smear examination was performed with participants at every 1-2 month interval. A nested PCR test was performed to confirm the mono-infection with P. vivax. Of 114 participants, 28 (24.6%) recurred subsequently. The median (IQR) duration of the first recurrence was 3.1 (2.2-5.8) months which ranged from 1.2 to 15.1 months, including initial 28 days. Participants with history of vivax malaria had significantly higher risk of recurrence, with hazard ratio (HR) (95% CI) of 2.62 (1.24-5.54) (P = 0.012). Severity of disease (11.4%, 13/114) was not associated (P = 1.00) with recurrence. Of 28 recurrence cases, the nPCR proved that P. vivax mono-infection recurrence rate was at least 72.7% (16/22) at first recurrence. In Udupi district, PQ dose of 0.25 mg/kg/day over 14 days seems inadequate to prevent recurrence in substantial proportion of vivax malaria. Patients with a history of vivax malaria are at high risk of recurrences.
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U2 - 10.3347/kjp.2016.54.6.733
DO - 10.3347/kjp.2016.54.6.733
M3 - Article
C2 - 28095658
AN - SCOPUS:85010774013
SN - 0023-4001
VL - 54
SP - 733
EP - 742
JO - Korean Journal of Parasitology
JF - Korean Journal of Parasitology
IS - 6
ER -