Table 2 Comparison of hematological changes and prevalence of other adverse events following administration of SLD primaquine
From: Is it time for Africa to adopt primaquine in the era of malaria control and elimination?
Author, country | G6PD deficiency vs normal | Hb changes and other AEs | Prevalence of AEs | SAE | Treatment required |
|---|---|---|---|---|---|
Gonçalves et al. 2016 [75], Burkina Faso | No | The mean relative percentage Hb drop (− 7.8 g/dL in AL + PQ, − 5.7 g/dL in AL) was more pronounced in individuals receiving 0.25 mg/kg PQ than in those who received AL alone but was not statistically significant. Other observed AEs were mild or moderate and were not different between treatment groups | A total number of subjects with AEs was not reported 18 AEs occurred in the ACT + PQ arm 15 AEs occurred in AL alone | None | None |
Mwaiswelo et al. 2016 [10], Tanzania | Yes | Mean absolute Hb drop (−1.48 g/dL in G6PD deficient, − 0.74 in G6PD normal) was statistically significantly different between G6PD status, but relative percentage Hb drop (− 12.6 g/dL in G6PD deficient, − 6.2 in G6PD normal) was not significantly different between G6PD deficient and G6PD normal subjects treated with PQ. The majority of the AEs were mild and self-limiting | 42.7% (47/110) in ACT + PQ 40.9% (45/110) in ACT alone | None | None |
Bancone et al. 2016 [79], Thailand | Yes | Mean relative Hb drop (− 5.2 g/dL in G6PD deficient, − 3.2 g/dL in G6PD normal) were significantly greater in G6PD deficient than G6PD normal subjects in the PQ arm but normalized during follow-up | A total number of subjects with AEs was not reported Dizziness occurred in 4.8% (79/1659) of subjects | ||
Dicko et al. 2016 [13], Mali | No | Within person changes in Hb concentration were not significant in any of the treatment groups at any time point | 40.0% (6/15) in ACT + PQ 40.0% (6/15) in ACT alone | None | None |
Tine et al,. 2017 [11], Senegal | Yes | The mean absolute Hb drop (-1.8 g/dL in G6PD deficient, -1.4 g/dL in G6PD normal) was significantly greater in G6PD deficient than G6PD normal treated with PQ. Only one patient developed moderately severe anemia. Dark urine was more frequent in patients who received PQ. Incidences of AEs were similar in both treatment groups | A total number of subjects with AEs was not reported 205 AEs occurred in the ACT + PQ arm 180 AEs occurred in ACT alone | None | None |
Bastiaens et al. 2018 [12], Burkina Faso and The Gambia | Yes | The mean absolute Hb drop was significant in G6PD deficient than in G6PD normal patients in Burkina Faso (− 0.92 g/dL in G6PD deficient, − 0.64 in G6PD normal), but was not significant in The Gambia (− 0.99 g/dL in G6PD deficient, − 1.1 g/dL in G6PD normal). PQ was well tolerated with the majority of observed AEs being mild | 43.3% (13/30) in ACT + PQ 40.0% (4/10) in AL alone | None | None |
Dicko et al., 2018 [76], Mali | No | Within person change in relative percentage of Hb was not significantly different between treatment arms | 65.0% (13/20) in SP + AQ + PQ 55.0% (11/20) in DP alone | None | None |
Raman et al. 2019 [14], South Africa | Yes | Mean Hb drop (values not indicated) was more prevalent in G6PD deficient than G6PD normal individuals. Anemia during follow-up was more prevalent in G6PD normal than in G6PD deficient. Other observed AEs were common in both groups, and the majority was mild | 31.4% (22/70) in ACT + PQ 26.0% (18/69) in ACT alone | Renal impairment in PQ arm. But the patient failed to disclose a history of renal impairment | None |