Low dose primaquine to prevent malaria transmission

Bousema , Teun

Currently available malaria drugs do not fully prevent onward transmission of malaria to mosquitoes. Until 2012, the World Health Organization recommended adding a single dose of primaquine at 0.75mg/kg to standard antimalarials to prevent transmission. However, the  implementation of this primaquine dose was affected safety concerns. A MSc student from Nijmegen previously demonstrated that 0.75mg/kg primaquine can cause significant haemolysis in individuals who are G6PD deficient. This prompted studies on a safer, efficacious dose of primaquine. This week, the team of Teun Bousema published the first conclusive efficacy study on low dose primaquine to prevent malaria transmission in The Lancet Infectious Diseases. Together with international colleagues, his team demonstrated in Mali that a primaquine dose of 0.25mg/kg, threefold lower than the previously recommended dose, is efficacious in preventing malaria transmission. Studies to confirm the safety of this dose in vulnerable groups are current ongoing in Burkina Faso.


Primaquine to reduce transmission of Plasmodium falciparum malaria in Mali: a single-blind, dose-ranging, adaptive randomised phase 2 trial


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