Table 1 Previous large-scale administrations of primaquine for control of malaria in different parts of the world
From: Is it time for Africa to adopt primaquine in the era of malaria control and elimination?
Author, country, year | Drug regimen, duration of intervention | Target population G6PD deficiency variant | Target population size (coverage) | Safety |
|---|---|---|---|---|
Alving et al. [54], USA, 1950–1953 | PQ 15 mg for 14 days Duration: 4 years | Soldiers returning from Korean war G6PD A- variant | 250,000 | Hemolysis occurred in half a dozen |
Kondrashin et al. [9], Afghanistan, 1971–1974 | PQ 1971–1973 Duration: 3 years 1973–1974 Duration: 2 years | All individuals (except infants, pregnant, chronically ill) All individuals (except infants, pregnant, chronically ill) Mediterranean variant | 1937–14,028 (≥ 90%) 78,000 (not described) | Drug highly tolerated and safe 1% side effects: fatigue, headache, backpain, GIT disorders |
Kondrashin et al. [9], Azerbaijan, 1971–1975 | PQ 15 mg daily for 14 days Duration: 5 years | All individuals (except infants, pregnant, lactating mothers) Mediterranean variant | 10,587–106,555 (87–93%) | ≤ 4% had adverse effects ≤ 1% of G6PD deficient subjects had severe adverse effects i.e. red to black urine Hb drop of 3–5 g/dL occurred in G6PD deficient, and 1–2 g/dL in normal subjects |
Hsiang et al. [60], Jiangsu, 1973–1983 | 1973–1976: PQ 30 mg daily for 4 days plus pyrimethamine 50 mg daily. Duration: 4 years 1977–1983: PQ 22.5 mg plus pyrimethamine 12.5 mg daily for 8 days. Duration: 7 years | All individuals in rural areas All index cases from previous year and their contacts | 13,389,482–27,974,966 4,446,687–16,534,356 | 49 G6PD deficiency individuals had acute hemolysis |
Garfield et al. [61], Nicaragua, 1981–1982 | CQ 350–1500 mg plus PQ 10–45 mg over 3 days Duration: 3 years | All individuals ≥ 1 year | 1,900,000 (80%) | Not described |
Kondrashin et al. [9], Tajikistan, 1983–1985 | PQ (dosage and regimen not described) Duration: 3 years | All individuals except infants, pregnant women, and chronically ill Dushanbe | 80,000 (77%) | Side effects were very low (No hard data) |
Luo et al., [67], China, 1985–1994 | CQ 1500 mg plus PQ 90 mg for 3 consecutive days Duration: 10 years | All individuals | 1,052,170 (not described) | Not described |
Han et al. [68], Yeom et al. [69], Republic of Korea, 1997–2005 | PQ 15 mg/day for 14 days for retired soldiers. CQ 300 mg weekly for active soldiers Duration: 9 years | Active and retired soldiers. (G6PD subjects included) | 985,282 | Not described |
Kondrashin et al. [9], Tajikistan, 1998–1999 | PQ (dosage and regimen not described) Duration: 2 years | All individuals Dushanbe | 257,200–512,000 (not described) | Not described |
Hsiang et al. [60], Jiangsu, 2000–2009 | CQ 400 mg daily for 3 days plus PQ 22.5 mg daily for 8 days Duration: 10 years | Index cases of past 1–2 years and all contacts (excluded < 3 years, pregnant, and serious ill G6PD deficient individuals included | 1,863,399–1,926,183 (60–98%) | 7 subjects, 5 in 2003 and 2 in 2007 experienced hemolysis |
Pant et al., [70], DPRK 2002–2010 | PQ 15 mg daily for 14 days Duration: 6 years | All individuals ≥ 5 years (except pregnant women and patients with lupus, arthritis, leukemia, hepatitis, or history of hemolysis/hypersensitivity after taking PQ) | 378,366–4,904,261 (94–98%) | ≤ 4% had adverse effects No cases of severe hemolysis were observed |
Deng et al. [71], Comoros Island, 2012 | DP plus PQ (dose not described) Duration: 3 months | All individuals except children < 6 months old, pregnant women in 3rd month of conception, patients with liver or kidney disease | 97,164 (85.7–93.2%) | 153 subjects had adverse effects and were mild. Headache, loss of appetite, dizziness and nausea were the most common adverse effects reported No death or serious adverse effect occurred |