Efficacy of Single-Dose Primaquine With Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis.

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dc.contributor.authorMwaiswelo, Richard O.
dc.date.accessioned2022-04-01T12:21:18Z
dc.date.available2022-04-01T12:21:18Z
dc.date.issued2020
dc.description.abstractBackground Since the World Health Organization recommended single low-dose (0.25 mg/kg) primaquine (PQ) in combina-tion with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant Plasmodium falcip-arum, several single-site studies have been conducted to assess efficacy. Methods An individual patient meta-analysis to assess gametocytocidal and transmission-blocking efficacy of PQ in combina-tion with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (1) gametocyte car-riage in the first 2 weeks post treatment; and (2) the probability of infecting at least 1 mosquito or of a mosquito becoming infected. Results In 2574 participants from 14 studies, PQ reduced PCR-determined gametocyte carriage on days 7 and 14, most ap-parently in patients presenting with gametocytemia on day 0 (odds ratio [OR], 0.22; 95% confidence interval [CI], .17–.28 and OR, 0.12; 95% CI, .08–.16, respectively). Rate of decline in gametocyte carriage was faster when PQ was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (P= .010 for day 7). Addition of 0.25 mg/kg PQ was associ-ated with near complete prevention of transmission to mosquitoes. Conclusions Transmission blocking is achieved with 0.25 mg/kg PQ. Gametocyte persistence and infectivity are lower when PQ is combined with AL compared to DP. Keywords. single low-dose primaquine; Plasmodium falciparum; gametocytemia.en_US
dc.identifier.citationStepniewska, K., Humphreys, G.S., Gonçalves, B.P., Craig, E., Gosling, R., Guerin, P.J., Price, R.N., Barnes, K.I., Raman, J., Smit, M. and D'Alessandro, U., 2020. Efficacy of single-dose primaquine with artemisinin combination therapy on Plasmodium falciparum gametocytes and transmission: an individual patient meta-analysis. Journal of Infectious Disease, (jiaa498).en_US
dc.identifier.otherhttps://academic.oup.com/jid/advance-article/doi/1...
dc.identifier.urihttp://hdl.handle.net/123456789/947
dc.language.isoenen_US
dc.publisherJournal of Infectious Diseaseen_US
dc.subjectPlasmodium falciparumen_US
dc.subjectGametocytemia.en_US
dc.subjectSingle-Dose Primaquineen_US
dc.titleEfficacy of Single-Dose Primaquine With Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis.en_US
dc.typeArticleen_US

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