Oral Presentation First Malaria World Congress 2018

Primaquine radical cure  of malaria - Trials and tribulations (#41)

Ric Price 1
  1. Menzies School of Health Research, Tiwi, NT, Australia

Outside of subsaharan Africa the timely elimination of malaria willr equire the widespread implementation of the effective radical cure of malaria, in which all stages of the parasite are targeted.  Vivax’s ability to form dormant liver stages (hypnozoites) and to recur weeks to months after a primary infection requires treatment of both the blood and liver stages of the parasite. Currently, the only widely available drug to eliminate hypnozoites from the human host is primaquine (PQ) a drug that can cause significant risk of haemolysis in individuals with g6PD deficiency. The World Health Organisations (WHO) treatment guidelines recommend that where possible patients are tested for G6PD deficiency prior to prescribing PQ, and that the drug should be administered over 14 days to reduce the risk of adverse events. The prolonged treatment course and requirement for G6PD testing are major obstacles to healthcare providers, who are often reluctant to prescribe PQ, and patients, who are reluctant to take a full course of treatment. The benefits of primaquine radical cure in reducing parasite transmission, morbidity and even mortality must be quantified and weighed against the dangers of its toxicity. An overview of the challenges of achieving this will be presented, as an introduction to the four other speakers in the session, who will provide new data on the risks and benefits of primaquine radical cure and its role in elimination efforts.