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

Abstract:

Background. Since the World Health Organization recommended single low-dose (0.25 mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant Plasmodium falciparum, 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 combination with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (1) gametocyte carriage 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 apparently 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 artemetherlumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (P = .010 for day 7). Addition of 0.25 mg/kg PQ was associated 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.
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APA

Stepniewska, K (2024). Efficacy of Single-Dose Primaquine With Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis. Afribary. Retrieved from https://afribary.com/works/efficacy-of-single-dose-primaquine-with-artemisinin-combination-therapy-on-plasmodium-falciparum-gametocytes-and-transmission-an-individual-patient-meta-analysis

MLA 8th

Stepniewska, Kasia "Efficacy of Single-Dose Primaquine With Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis" Afribary. Afribary, 10 Mar. 2024, https://afribary.com/works/efficacy-of-single-dose-primaquine-with-artemisinin-combination-therapy-on-plasmodium-falciparum-gametocytes-and-transmission-an-individual-patient-meta-analysis. Accessed 27 May. 2024.

MLA7

Stepniewska, Kasia . "Efficacy of Single-Dose Primaquine With Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis". Afribary, Afribary, 10 Mar. 2024. Web. 27 May. 2024. < https://afribary.com/works/efficacy-of-single-dose-primaquine-with-artemisinin-combination-therapy-on-plasmodium-falciparum-gametocytes-and-transmission-an-individual-patient-meta-analysis >.

Chicago

Stepniewska, Kasia . "Efficacy of Single-Dose Primaquine With Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis" Afribary (2024). Accessed May 27, 2024. https://afribary.com/works/efficacy-of-single-dose-primaquine-with-artemisinin-combination-therapy-on-plasmodium-falciparum-gametocytes-and-transmission-an-individual-patient-meta-analysis