التفاصيل البيبلوغرافية
| العنوان: |
Safety and efficacy of primaquine in patients with Plasmodium vivax malaria from South Asia: a systematic review and individual patient data meta-analysis |
| المؤلفون: |
Verma, Reena, Commons, Robert J, Gupta, Apoorv, Rahi, Manju, Nitika, Bharti, Praveen K, Thriemer, Kamala, Rajasekhar, Megha, Singh-Phulgenda, Sauman, Adhikari, Bipin, Alam, Mohammad Shafiul, Ghimire, Prakash, Khan, Wasif A, Kumar, Rishikesh, Leslie, Toby, Ley, Benedikt, Llanos-Cuentas, Alejandro, Pukrittayakamee, Sasithon, Rijal, Komal Raj, Rowland, Mark, Saravu, Kavitha, Simpson, Julie A, Guerin, Philippe J, Price, Ric N, Sharma, Amit |
| المساهمون: |
Bill and Melinda Gates Foundation |
| المصدر: |
BMJ Global Health ; volume 8, issue 12, page e012675 ; ISSN 2059-7908 |
| بيانات النشر: |
BMJ |
| سنة النشر: |
2023 |
| مصطلحات موضوعية: |
Public Health, Environmental and Occupational Health, Health Policy |
| الوصف: |
Background The optimal dosing of primaquine to prevent relapsing Plasmodium vivax malaria in South Asia remains unclear. We investigated the efficacy and safety of different primaquine regimens to prevent P. vivax relapse. Methods A systematic review identified P. vivax efficacy studies from South Asia published between 1 January 2000 and 23 August 2021. In a one-stage meta-analysis of available individual patient data, the cumulative risks of P. vivax recurrence at day 42 and 180 were assessed by primaquine total mg/kg dose and duration. The risk of recurrence by day 180 was also determined in a two-stage meta-analysis. Patients with a >25% drop in haemoglobin to <70 g/L, or an absolute drop of >50 g/L between days 1 and 14 were categorised by daily mg/kg primaquine dose. Results In 791 patients from 7 studies in the one-stage meta-analysis, the day 180 cumulative risk of recurrence was 61.1% (95% CI 42.2% to 80.4%; 201 patients; 25 recurrences) after treatment without primaquine, 28.8% (95% CI 8.2% to 74.1%; 398 patients; 4 recurrences) following low total (2 to <5 mg/kg) and 0% (96 patients; 0 recurrences) following high total dose primaquine (≥5 mg/kg). In the subsequent two-stage meta-analysis of nine studies (3529 patients), the pooled proportions of P. vivax recurrences by day 180 were 12.1% (95% CI 7.7% to 17.2%), 2.3% (95% CI 0.3% to 5.4%) and 0.7% (95% CI 0% to 6.1%), respectively. No patients had a >25% drop in haemoglobin to <70 g/L. Conclusions Primaquine treatment led to a marked decrease in P. vivax recurrences following low (~3.5 mg/kg) and high (~7 mg/kg) total doses, with no reported severe haemolytic events. PROSPERO registration number CRD42022313730. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1136/bmjgh-2023-012675 |
| الإتاحة: |
https://doi.org/10.1136/bmjgh-2023-012675Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.C1FE709E |
| قاعدة البيانات: |
BASE |
