Is it time for Africa to adopt primaquine in the era of malaria control and elimination?

Abstract

Keypoints Sub-Saharan Africa contributes about 95% of global malaria cases and related deaths. Despite safety concerns adoption of SLD primaquine is needed to further reduce malaria transmission, an essential prerequisite for the elimination of the infection in Africa. Large scale administrations of primaquine for control and elimination of malaria have been implemented in other parts of the world where there are severe variants of G6PD deficiency, but only around 1% of the population had mild adverse effects. African G6PD A- is a milder variant of deficiency, and the hemolysis that occurs following a single 0.25 mg/kg primaquine administration in this group is usually mild and self-limiting. With proper planning and preparation for the management of adverse effects, administration of SLD primaquine plus effective schizonticides, in a form of mass drug administration or seasonal malaria chemoprevention can be used in Africa to reduce malaria transmission.

Keywords

• Malaria
• Primaquine
• G6PD deficiency
• Safety
• Control
• Elimination