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Use of primaquine as a radical treatment for P. vivax and P. ovale malaria in France

Date du document : 18/05/2018

Date de mise en ligne : 20/08/2018

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Maladies transmissibles Prévention Paludisme Plasmodium ovale Plasmodium vivax Primaquine
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The French High Council for Public Health (HCSP) has revised its 2008 statement on radical treatment for Plasmodium vivax and Plasmodium ovale malaria with primaquine, the only available medicinal product for this indication, in conjunction with chloroquine or artemisinin-based combination therapy.

Based on WHO’s 2015 recommendations, the national context and knowledge about G6PD deficiency, the HCSP recommends a systematic quantitative screening of G6PD deficiency and of anaemia prior to the prescription of primaquine for radical treatment of P. vivax or P. ovale malaria.

If no G6PD deficiency is detected, it recommends the immediate prescription of primaquine at a dosing regimen of 0.5 mg/kg/day for 14 days, with medical follow-up of malaria and of tolerance of primaquine.

If G6PD deficiency is detected and less than 30% in men and between 30% and 80% in women, it recommends prescription of primaquine at a dosing regimen of 0.75 mg/kg/week for 8 weeks, only if close monitoring of the patient and swift transfusion are possible in case of acute anaemia.

The HCSP reminds and underlines the contraindications regarding primaquine treatment that must be followed: severe or known variant B G6PD deficiency, pregnancy, breastfeeding or infants under six months old.

The HCSP advocates the development of point-of-care tests to screen for G6PD deficiency, and of therapeutic trials.

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