Is it time for Africa to adopt primaquine in the era of malaria control and elimination?

Mwaiswelo, Richard O.; Kabuga, Hamis

Is it time for Africa to adopt primaquine in the era of malaria control and elimination?

dc.contributor.author	Mwaiswelo, Richard O.
dc.contributor.author	Kabuga, Hamis
dc.date.accessioned	2022-04-01T10:52:26Z
dc.date.available	2022-04-01T10:52:26Z
dc.date.issued	2022-02-25
dc.description.abstract	Primaquine is a gametocytocidal drug known to significantly reduce malaria transmission. However, primaquine induces a dose-dependent acute hemolytic anemia (AHA) in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency that has led to a limited use of the drug especially in Africa where the condition is common. The World Health Organization (WHO) now recommends a single low dose (SLD) of primaquine (0.25 mg/kg) as P. falci-parum gametocytocidal without the need for prior screening of G6PD status. Adoption and implementation of SLD primaquine in Africa may probably reduce malaria transmission, a pre-requisite for malaria elimination. This review therefore, focused on the safety of primaquine for control of malaria in Africa. The literature search was performed using online database Google Scholar, PubMed, HINARI, and Science Direct. Search terms used were “malaria”, “pri-maquine”, “safety”, “G6PD deficiency”, “large scale” or “mass administration”. Clinical trials in many African countries have shown SLD primaquine to be safe especially in a milder African G6PD A- variant. Likewise, large-scale primaquine administrations outside Africa involving hundreds of thousands to tenths of millions of participants and with severe variants of G6PD deficiency have also shown primaquine to be safe and well-tolerated. Fourteen deaths associated with primaquine have been reported globally over the past 6 decades, but none occurred following the administra-tion of SLD primaquine. Available evidence shows that the WHO-recommended SLD primaquine dose added to effec-tive schizonticides is safe and well-tolerated even in individuals with G6PD deficiency, and therefore, it can be safely used in the African population with the mildest G6PD A- variant.	en_US
dc.identifier.citation	Mwaiswelo, R.O., Kabuga, H., Kweka, E.J. and Baraka, V., 2022. Is it time for Africa to adopt primaquine in the era of malaria control and elimination?. Tropical Medicine and Health, 50(1), pp.1-13.	en_US
dc.identifier.other	https://doi.org/10.1186/s41182-022-00408-5
dc.identifier.uri	http://hdl.handle.net/123456789/943
dc.language.iso	en	en_US
dc.publisher	Tropical Medicine and Health	en_US
dc.subject	Malaria	en_US
dc.subject	Primaquine	en_US
dc.subject	G6PD deficiency	en_US
dc.title	Is it time for Africa to adopt primaquine in the era of malaria control and elimination?	en_US
dc.type	Article	en_US