Effect of weekly versus daily primaquine on <i>Plasmodium vivax</i> malaria recurrences: A real-life cohort study

Brito-Sousa, Jose Diego; Phanor, Jeffe; Balieiro, Patricia Carvalho da Silva; Silva-Neto, Alexandre Vilhena; Cordeiro, Jady Shayenne Mota; Vitor-Silva, Sheila; Mendes, Maxwell; Sampaio, Vanderson Souza; Melo, Gisely Cardoso de; Lacerda, Marcus; Monteiro, Wuelton

doi:10.1590/0037-8682-0738-2021

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Revista da Sociedade Brasileira de Medicina Tropical

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Sumário

Short Communication • Rev. Soc. Bras. Med. Trop. 55 • 2022 • https://doi.org/10.1590/0037-8682-0738-2021 copy

Effect of weekly versus daily primaquine on Plasmodium vivax malaria recurrences: A real-life cohort study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background:

Although primaquine (PQ) is indicated for G6PD-deficient patients, data on weekly PQ use in Brazil are limited.

Methods:

We aimed to investigate malaria recurrences among participants receiving daily and weekly PQ treatments in a real-life setting of two municipalities in the Amazon between 2019 and 2020.

Results:

Patients receiving weekly PQ treatment had a lower risk of recurrence than those receiving daily PQ treatment (risk ratio: 0.62, 95% confidence interval: 0.41-0.94), using a model adjusted for study site.

Conclusions:

Weekly PQ use did not increase the risk of malaria recurrence. Further studies with larger populations are warranted.

Keywords:
Weekly primaquine; Recurrences; Brazilian Amazon; Elimination; G6PD deficiency

	PQ Treatment
	Total	Weekly	Daily
Variable	n=1,444	n=122	n=1,322
Municipality (n=1,444; 100%)
Rio Preto da Eva, AM	450 (31.2%)	83 (68.0%)	367 (27.8%)
Mâncio Lima, AC	994 (68.8%)	39 (32.0%)	955 (72.2%)
Age (SD)	27.3 (18.0)	30.2 (19.8)	27.0 (17.9)
Gender (female) (n=1,444; 100%)	558 (38.6%)	53 (43.4%)	505 (38.2%)
School education (n=1,288; 89.20%)
Illiterate	23 (1.8%)	8 (7.0%)	15 (1.3%)
Incomplete elementary school	928 (72.0%)	76 (66.7%)	852 (72.6%)
Complete primary education	106 (8.2%)	10 (8.8%)	96 (8.2%)
Incomplete high school	77 (6.0%)	8 (7.0%)	69 (5.9%)
Complete high school	127 (9.9%)	12 (10.5%)	115 (9.8%)
Incomplete higher education	9 (0.7%)	0 (0.0%)	9 (0.8%)
Complete higher education	18 (1.4%)	0 (0.0%)	18 (1.5%)
Zone of residence (n=1,299; 89.96%)
Rural	1,165 (89.7%)	79 (87.8%)	1,086 (89.8%)
Urban	134 (10.3%)	11 (12.2%)	123 (10.2%)
Parasitemia (mm ³ ) at baseline (n=1,253; 86.77%)
<199	242 (19.3%)	16 (14.3%)	226 (19.8%)
200-300	311 (24.8%)	21 (18.8%)	290 (25.4%)
301-5,000	235 (18.8%)	15 (13.3%)	220 (19.3%)
501-10,000	346 (27.6%)	33 (29.5%)	313 (27.4%)
10,001-100,000	119 (9.5%)	27 (24.1%)	92 (8.1%)
At least one recurrence by day 180 (n=1,444; 100%)	285 (19.7%)	20 (16.4%)	265 (20.0%)
Number of recurrences in 180 days (n=285;19.74%)
1	223 (78.2%)	15 (75.0%)	208 (78.5%)
2	42 (14.7%)	3 (15.0%)	39 (14.7%)
3	17 (6.0%)	2 (10.0%)	15 (5.7%)
4	3 (1.1%)	0 (0.0%)	3 (1.1%)

Sociedade Brasileira de Medicina Tropical - SBMT Caixa Postal 118, 38001-970 Uberaba MG Brazil, Tel.: +55 34 3318-5255 / +55 34 3318-5636/ +55 34 3318-5287, http://rsbmt.org.br/ - Uberaba - MG - Brazil
E-mail: rsbmt@uftm.edu.br

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[1] Corresponding author: Wuelton Monteiro. e-mail:wueltonmm@gmail.com