2018
DOI: 10.1371/journal.pone.0190272
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Safety of single low-dose primaquine in glucose-6-phosphate dehydrogenase deficient falciparum-infected African males: Two open-label, randomized, safety trials

Abstract: BackgroundPrimaquine (PQ) actively clears mature Plasmodium falciparum gametocytes but in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals can cause hemolysis. We assessed the safety of low-dose PQ in combination with artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP) in G6PDd African males with asymptomatic P. falciparum malaria.Methods and findingsIn Burkina Faso, G6PDd adult males were randomized to treatment with AL alone (n = 10) or with PQ at 0.25 (n = 20) or 0.40 mg/kg (n… Show more

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Cited by 35 publications
(50 citation statements)
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“…Pharmacovigilance in this study was planned to ensure training, detection, reporting, management, and follow-up of adverse events by both passive and active surveillance. In line with other studies [ 13 , 14 , 16 , 34 37 ], MDA with DP and SLD primaquine was deemed safe, with some transient adverse events and no reports of clinically serious adverse events. In addition, acceptability of the intervention was high with over 90% of survey respondents expressing willingness to participate in future MDAs.…”
Section: Discussionsupporting
confidence: 86%
“…Pharmacovigilance in this study was planned to ensure training, detection, reporting, management, and follow-up of adverse events by both passive and active surveillance. In line with other studies [ 13 , 14 , 16 , 34 37 ], MDA with DP and SLD primaquine was deemed safe, with some transient adverse events and no reports of clinically serious adverse events. In addition, acceptability of the intervention was high with over 90% of survey respondents expressing willingness to participate in future MDAs.…”
Section: Discussionsupporting
confidence: 86%
“…Accumulating evidence from Africa [ 63 65 ] and Asia [ 66 ], suggests that single-dose PQ at 0.25 mg/kg as a gametocytocidal drug to block transmission would be safe in areas where G6PD deficiency A− and other type 2 variants predominates, comparable to the settings in this study site. Encouraging evidence from neighbouring Swaziland, a country with a similar G6PD deficiency prevalence profile to South Africa, suggests the roll-out of a low-dose PQ policy with no prior genetic profiling requirement, at least in none G6PD-deficient participants by RDT, is associated with good safety profiles [ 53 ].…”
Section: Discussionmentioning
confidence: 58%
“…Most studies evaluating the safety of PQ intake in G6PDd patients are based on P. falciparum infections receiving a single dose of PQ administered at different concentrations (0.25 or 0.4 mg/kg [ 34 , 35 ]; 0.4–0.5 mg/kg [ 36 ]; 0.1, 0.4, 0.75 mg/kg [ 37 ]; 0.7 mg/kg [ 38 ]). Those studies seem to agree on two points: that the adverse effects of PQ at low doses are usually mild or moderate even in patients with G6PDd; and that safety depends primarily on primaquine doses, as well as the variant of G6PD deficiency.…”
Section: Discussionmentioning
confidence: 99%