Appropriate Time for Primaquine Treatment to Reduce Plasmodium falciparum Transmission in Hypoendemic Areas.
10.3347/kjp.2010.48.2.179
- Author:
Polrat WILAIRATANA
1
;
Srivicha KRUDSOOD
;
Noppadon TANGPUKDEE
Author Information
1. Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand. tmpwl@mahidol.ac.th
- Publication Type:Brief Communication
- Keywords:
Plasmodium falciparum;
artemisinin-combination therapy;
primaquine;
malaria transmission blocking
- From:The Korean Journal of Parasitology
2010;48(2):179-182
- CountryRepublic of Korea
- Language:English
-
Abstract:
Artemesinin-combination therapies (ACT) for falciparum malaria reduce gametocyte carriage, and therefore reduce transmission. Artemisinin derivatives will act against only young gametocytes whereas primaquine acts on mature gametocytes which are present usually in the circulation at the time when the patient presents for treatment. Both artemisinin derivatives and primaquine have short half-lives, less than 1 hr and 7 hr, respectively. Therefore, asexual parasites or young gametocytes remain after completed ACT. A single dose of primaquine (0.50-0.75 mg base/kg) at the end of ACT can kill only mature gametocytes but cannot kill young gametocytes (if present). Remaining asexual forms after completion of ACT course, e.g., artesunate-mefloquine for 3 days, may develop to mature gametocytes 7-15 days later. Thus, an additional dose of primaquine (0.50-0.75 mg base/kg) given 2 weeks after ACT completion may be beneficial for killing remaining mature gametocytes and contribute to more interruption of Plasmodium falciparum transmission than giving only 1 single dose of primaquine just after completing ACT.
