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Determinants of primaquine and carboxyprimaquine exposures in children and adults with Plasmodium vivax malaria

August 17, 2021 - 16:25 -- Open Access
Chu CS, Watson JA, Phyo AP, Win HH, Yotyingaphiram W, Thinraow S, Soe NL, Aung AA, Wilaisrisak P, Kraft K, Imwong M, Hanpithakpong W, Blessborn D, Tarning J, Proux S, Ling C, Nosten FH, White NJ
Antimicrob Agents Chemother. 2021 Aug 16:AAC0130221

Primaquine is the only widely available drug for radical cure of Plasmodium vivax malaria. There is uncertainty whether the pharmacokinetic properties of primaquine are altered significantly in childhood or not.

Relapse of Plasmodium vivax and Plasmodium ovale malaria with and without primaquine treatment in a non-endemic area

July 6, 2021 - 14:43 -- Open Access
Wångdahl A, Sondén K, Wyss K, Stenström C, Björklund D, Zhang J, Hervius Askling H, Carlander C, Hellgren U, Färnert A
Clin Infect Dis. 2021 Jul 3:ciab610

The effect of primaquine in preventing P. vivax relapses from dormant stages is well established. For P. ovale, the relapse characteristics and the use primaquine is not as well studied. We set to evaluate the relapsing properties of these two species, in relation to primaquine use among imported malaria cases in a non-endemic setting.

Interactions of primaquine and chloroquine with PEGylated phosphatidylcholine liposomes

June 16, 2021 - 15:09 -- Open Access
Miatmoko A, Nurjannah I, Nehru NF, Rosita N, Hendradi E, Sari R, Ekowati J
Sci Rep. 2021 Jun 14;11(1):12420

This study aimed to analyze the interaction of primaquine (PQ), chloroquine (CQ), and liposomes to support the design of optimal liposomal delivery for hepatic stage malaria infectious disease. The liposomes were composed of hydrogenated soybean phosphatidylcholine, cholesterol, and distearoyl-sn-glycero-3-phosphoethanolamine-N-(methoxy[polyethyleneglycol]-2000), prepared by thin film method, then evaluated for physicochemical and spectrospic characteristics. The calcein release was further evaluated to determine the effect of drug co-loading on liposomal membrane integrity.

Evaluation of the effect of supervised anti-malarial treatment on recurrences of Plasmodium vivax malaria

June 16, 2021 - 13:11 -- Open Access
Kelry Mazurega Oliveira Dinelly, Sheila Vitor-Silva, Gisely Cardoso Melo, et al.
Malaria Journal 2021 20:266, 13 June 2021

Relapses in vivax malaria have posed great challenges for malaria control, and they also account for a great proportion of reported cases. Knowing the real effectiveness of a 7-day primaquine (PQ) scheme is crucial in order to evaluate not only the cost-effectiveness of implementing new anti-hypnozoite drugs, but also how health education strategies can guarantee better compliance and be reinforced. This study aimed to evaluate the effect of daily treatment with chloroquine and PQ supervised by health workers versus prescription without supervision.

G6PD deficiency among malaria-infected national groups at the western part of Myanmar with implications for primaquine use in malaria elimination

June 16, 2021 - 09:51 -- Open Access
Han KT, Han ZY, Aye KH, Wai KT, Thi A, Cui L, Sattabongkot J
Trop Med Health. 2021 Jun 9;49(1):47

Glucose 6-phosphate dehydrogenase deficiency (G6PDd) plays a central role in readiness assessment for malaria elimination in Myanmar by 2030 that includes primaquine (PQ) use. The risk of hemolysis in G6PDd individuals hampers the widespread use of primaquine safely in malaria-infected patients. In the pre-elimination era, it is important to screen initially for asymptomatic malaria in combination with G6PD deficiency by applying more sensitive diagnostic tools. Therefore, this study examined the proportion of G6PDd and the distribution of G6PD genotypes among malaria-infected national groups in Myanmar before initiation of malaria elimination strategies.

Not Open Access | Impact of CYP2D6 Genetic Variation on Radical Cure of Plasmodium vivax Malaria

June 1, 2021 - 15:45 -- NOT Open Access
Suarez-Kurtz G
Clin Pharmacol Ther. 2021 May 27

Plasmodium vivax is the most widespread human malaria parasite, with 2.5 billion people at risk of infection worlwide. P. vivax forms liver hypnozoites which trigger further symptomatic episodes (relapses) weeks or months after the initial episode. Radical cure of vivax malaria requires hypnozoitocide therapy to prevent relapses. The two FDA-approved hypnozoiticides for human use, primaquine and tafenoquine, are pro-drugs, that require in vivo conversion into metabolites with redox activity. This mini-review focuses on the association between CYP2D6-mediated hydroxylation and hypnozoiticide efficacy of primaquine and tafenoquine.

The integrity and stability of specimens under different storage conditions for glucose-6-phosphate dehydrogenase deficiency screening using WST-8

May 5, 2021 - 08:56 -- Open Access
Chamchoy K, Praoparotai A, Pakparnich P, Sudsumrit S, Swangsri T, Chamnanchanunt S, Songdej D, Imwong M, Boonyuen U
Acta Trop. 2021 May;217:105864

Accurate measurement of glucose-6-phosphate dehydrogenase (G6PD) activity is critical for malaria treatment as misclassification of G6PD deficiency could cause serious harm to patients. G6PD activity should be assessed in blood samples on the day of collection. Otherwise, specimens should be stored under suitable conditions to prevent loss of G6PD activity.

Glucose-6-phosphate dehydrogenase mutations in malaria endemic area of Thailand by multiplexed high‐resolution melting curve analysis

April 21, 2021 - 15:07 -- Open Access
Usa Boonyuen, Duantida Songdej, Mallika Imwong, et al.
Malaria Journal 2021 20:194, 20 April 2021

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common enzymopathy in humans, is prevalent in tropical and subtropical areas where malaria is endemic. Anti-malarial drugs, such as primaquine and tafenoquine, can cause haemolysis in G6PD-deficient individuals. Hence, G6PD testing is recommended before radical treatment against vivax malaria. Phenotypic assays have been widely used for screening G6PD deficiency, but in heterozygous females, the random lyonization causes difficulty in interpreting the results. Over 200 G6PD variants have been identified, which form genotypes associated with differences in the degree of G6PD deficiency and vulnerability to haemolysis. This study aimed to assess the frequency of G6PD mutations using a newly developed molecular genotyping test.

NOT Open Access | Synthesis and biological evaluation of benzhydryl-based antiplasmodial agents possessing Plasmodium falciparum chloroquine resistance transporter (PfCRT) inhibitory activity

April 6, 2021 - 14:20 -- NOT Open Access
Relitti N, Federico S, Pozzetti L, Campiani G, et al.
Eur J Med Chem. 2021 Apr 5;215:113227

Due to the surge in resistance to common therapies, malaria remains a significant concern to human health worldwide. In chloroquine (CQ)-resistant (CQ-R) strains of Plasmodium falciparum, CQ and related drugs are effluxed from the parasite's digestive vacuole (DV). This process is mediated by mutant isoforms of a protein called CQ resistance transporter (PfCRT). CQ-R strains can be partially re-sensitized to CQ by verapamil (VP), primaquine (PQ) and other compounds, and this has been shown to be due to the ability of these molecules to inhibit drug transport via PfCRT.

Rolling out the radical cure for vivax malaria in Asia: a qualitative study among policy makers and stakeholders

March 24, 2021 - 14:50 -- Open Access
Bipin Adhikari, Ghulam Rhahim Awab and Lorenz von Seidlein
Malaria Journal 2021 20:164, 23 March 2021

Wide-spread implementation of treatment regimens for the radical cure of vivax malaria is hindered by a range of factors. This has resulted in an increase in the relative proportion of vivax malaria and is an important obstacle in the achievement of global malaria elimination by 2030. The main objective of this study was to explore the current policies guiding the treatment plans on vivax malaria, and the factors affecting the implementation of radical cure in South/South East Asian and Asian Pacific countries.


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