Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10823
Title: Safety of primaquine in infants with Plasmodium vivax malaria in Papua, Indonesia.
Authors: Setyadi, Agus
Arguni, Eggi
Kenangalem, Enny
Hasanuddin, Afdhal
Lampah, Daniel A
Thriemer, Kamala
Anstey, Nicholas M
Sugiarto, Paulus
Simpson, Julie A
Price, Ric N
Douglas, Nicholas M
Poespoprodjo, Jeanne R
Affiliation: Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia..
Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia..
Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Papua, Indonesia.. Mimika District Hospital, Timika, Papua, Indonesia..
Mitra Masyarakat Hospital, Timika, Indonesia..
Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Papua, Indonesia..
Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia..
Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.. Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia..
Mitra Masyarakat Hospital, Timika, Indonesia..
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia..
Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.. Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.. Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand..
Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.. Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia..
Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia. didot2266@yahoo.com.. Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Papua, Indonesia. didot2266@yahoo.com.. Mimika District Hospital, Timika, Papua, Indonesia. didot2266@yahoo.com..
Issue Date: 2-Apr-2019
Citation: Malaria journal 2019-04-02; 18(1): 111
Abstract: Primaquine (PQ) prevents relapses of vivax malaria but may induce severe haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. Data on the safety of primaquine in infants are limited. A retrospective, hospital-based cohort study of infants aged 1-12 months with vivax malaria was carried out in Timika, Papua province, Indonesia. Risks of admission, death and severe haematological outcomes within 30 days of first presentation were compared between infants who did and did not receive primaquine. Infants were not tested routinely for G6PD deficiency as per local guidelines. Between 2004 and 2013, 4078 infants presented to the hospital for the first time with vivax malaria, of whom 3681 (90.3%) had data available for analysis. In total 1228 (33.4%) infants were aged between 1 and 6 months and 2453 (66.6%) between 6 and 12 months of age. Thirty-three (0.9%) patients received low-dose primaquine (LDP), 174 (4.7%) received high-dose primaquine (HDP), 3432 (93.2%) received no primaquine (NPQ) and 42 patients received either a single dose or an unknown dose of primaquine. The risk of the Hb concentration falling by > 25% to less than 5 g/dL was similar in the LDP or HDP groups (4.3%, 1/23) versus the NPQ group (3.5%, 16/461). Three infants (1.4%) died following receipt of PQ, all of whom had major comorbidities. Seventeen patients (0.5%) died in the NPQ group. None of the infants had documented massive haemolysis or renal impairment. Severe clinical outcomes amongst infants treated with primaquine in Papua were rare. The risks of using primaquine in infancy must be weighed against the risks of recurrent vivax malaria in early life.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10823
DOI: 10.1186/s12936-019-2745-7
ORCID: http://orcid.org/0000-0003-1573-734X
Type: Journal Article
Subjects: Evaluation
Infants
Plasmodium vivax
Primaquine
Safety
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