Rationale for short course primaquine in Africa to interrupt malaria transmission

Alice C. Eziefula, Roly Gosling, Jimee Hwang, Michelle S. Hsiang, Teun Bousema, Lorenz Von Seidlein, Chris Drakeley

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Following the recent successes of malaria control in sub-Saharan Africa, the gametocytocidal drug primaquine needs evaluation as a tool to further reduce the transmission of Plasmodium falciparum malaria. The drug has scarcely been used in Africa because of concerns about its safety in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The evidence base for the use of primaquine as a transmission blocker is limited by a lack of comparable clinical and parasitological endpoints between trials. In March 2012, a group of experts met in London to discuss the existing evidence on the ability of primaquine to block malaria transmission, to define the roadblocks to the use of primaquine in Africa and to develop a roadmap to enable its rapid, safe and effective deployment. The output of this meeting is a strategic plan to optimize trial design to reach desired goals efficiently. The roadmap includes suggestions for a series of phase 1, 2, 3 and 4 studies to address specific hurdles to primaquines deployment. These include ex-vivo studies on efficacy, primaquine pharmacokinetics and pharmacodynamics and dose escalation studies for safety in high-risk groups. Phase 3 community trials are proposed, along with Phase 4 studies to evaluate safety, particularly in pregnancy, through pharmacovigilance in areas where primaquine is already deployed. In parallel, efforts need to be made to address issues in drug supply and regulation, to map G6PD deficiency and to support the evaluation of alternative gametocytocidal compounds.

Original languageEnglish (US)
Article number360
JournalMalaria Journal
Volume11
DOIs
StatePublished - 2012

Fingerprint

Primaquine
Malaria
Glucosephosphate Dehydrogenase Deficiency
Safety
Pharmacovigilance
Falciparum Malaria
Africa South of the Sahara
Drug and Narcotic Control
Pharmaceutical Preparations
Pharmacokinetics
Pregnancy

Keywords

  • 8-aminoquinoline
  • Africa
  • G6PD
  • Gametocyte
  • Glucose-6-phosphate dehydrogenase deficiency
  • Malaria
  • Plasmodium falciparum
  • Primaquine
  • Transmission

ASJC Scopus subject areas

  • Infectious Diseases
  • Parasitology

Cite this

Eziefula, A. C., Gosling, R., Hwang, J., Hsiang, M. S., Bousema, T., Von Seidlein, L., & Drakeley, C. (2012). Rationale for short course primaquine in Africa to interrupt malaria transmission. Malaria Journal, 11, [360]. https://doi.org/10.1186/1475-2875-11-360

Rationale for short course primaquine in Africa to interrupt malaria transmission. / Eziefula, Alice C.; Gosling, Roly; Hwang, Jimee; Hsiang, Michelle S.; Bousema, Teun; Von Seidlein, Lorenz; Drakeley, Chris.

In: Malaria Journal, Vol. 11, 360, 2012.

Research output: Contribution to journalArticle

Eziefula, AC, Gosling, R, Hwang, J, Hsiang, MS, Bousema, T, Von Seidlein, L & Drakeley, C 2012, 'Rationale for short course primaquine in Africa to interrupt malaria transmission', Malaria Journal, vol. 11, 360. https://doi.org/10.1186/1475-2875-11-360
Eziefula, Alice C. ; Gosling, Roly ; Hwang, Jimee ; Hsiang, Michelle S. ; Bousema, Teun ; Von Seidlein, Lorenz ; Drakeley, Chris. / Rationale for short course primaquine in Africa to interrupt malaria transmission. In: Malaria Journal. 2012 ; Vol. 11.
@article{5aae0d5db7b44066b037c05bde181ec0,
title = "Rationale for short course primaquine in Africa to interrupt malaria transmission",
abstract = "Following the recent successes of malaria control in sub-Saharan Africa, the gametocytocidal drug primaquine needs evaluation as a tool to further reduce the transmission of Plasmodium falciparum malaria. The drug has scarcely been used in Africa because of concerns about its safety in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The evidence base for the use of primaquine as a transmission blocker is limited by a lack of comparable clinical and parasitological endpoints between trials. In March 2012, a group of experts met in London to discuss the existing evidence on the ability of primaquine to block malaria transmission, to define the roadblocks to the use of primaquine in Africa and to develop a roadmap to enable its rapid, safe and effective deployment. The output of this meeting is a strategic plan to optimize trial design to reach desired goals efficiently. The roadmap includes suggestions for a series of phase 1, 2, 3 and 4 studies to address specific hurdles to primaquines deployment. These include ex-vivo studies on efficacy, primaquine pharmacokinetics and pharmacodynamics and dose escalation studies for safety in high-risk groups. Phase 3 community trials are proposed, along with Phase 4 studies to evaluate safety, particularly in pregnancy, through pharmacovigilance in areas where primaquine is already deployed. In parallel, efforts need to be made to address issues in drug supply and regulation, to map G6PD deficiency and to support the evaluation of alternative gametocytocidal compounds.",
keywords = "8-aminoquinoline, Africa, G6PD, Gametocyte, Glucose-6-phosphate dehydrogenase deficiency, Malaria, Plasmodium falciparum, Primaquine, Transmission",
author = "Eziefula, {Alice C.} and Roly Gosling and Jimee Hwang and Hsiang, {Michelle S.} and Teun Bousema and {Von Seidlein}, Lorenz and Chris Drakeley",
year = "2012",
doi = "10.1186/1475-2875-11-360",
language = "English (US)",
volume = "11",
journal = "Malaria Journal",
issn = "1475-2875",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Rationale for short course primaquine in Africa to interrupt malaria transmission

AU - Eziefula, Alice C.

AU - Gosling, Roly

AU - Hwang, Jimee

AU - Hsiang, Michelle S.

AU - Bousema, Teun

AU - Von Seidlein, Lorenz

AU - Drakeley, Chris

PY - 2012

Y1 - 2012

N2 - Following the recent successes of malaria control in sub-Saharan Africa, the gametocytocidal drug primaquine needs evaluation as a tool to further reduce the transmission of Plasmodium falciparum malaria. The drug has scarcely been used in Africa because of concerns about its safety in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The evidence base for the use of primaquine as a transmission blocker is limited by a lack of comparable clinical and parasitological endpoints between trials. In March 2012, a group of experts met in London to discuss the existing evidence on the ability of primaquine to block malaria transmission, to define the roadblocks to the use of primaquine in Africa and to develop a roadmap to enable its rapid, safe and effective deployment. The output of this meeting is a strategic plan to optimize trial design to reach desired goals efficiently. The roadmap includes suggestions for a series of phase 1, 2, 3 and 4 studies to address specific hurdles to primaquines deployment. These include ex-vivo studies on efficacy, primaquine pharmacokinetics and pharmacodynamics and dose escalation studies for safety in high-risk groups. Phase 3 community trials are proposed, along with Phase 4 studies to evaluate safety, particularly in pregnancy, through pharmacovigilance in areas where primaquine is already deployed. In parallel, efforts need to be made to address issues in drug supply and regulation, to map G6PD deficiency and to support the evaluation of alternative gametocytocidal compounds.

AB - Following the recent successes of malaria control in sub-Saharan Africa, the gametocytocidal drug primaquine needs evaluation as a tool to further reduce the transmission of Plasmodium falciparum malaria. The drug has scarcely been used in Africa because of concerns about its safety in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The evidence base for the use of primaquine as a transmission blocker is limited by a lack of comparable clinical and parasitological endpoints between trials. In March 2012, a group of experts met in London to discuss the existing evidence on the ability of primaquine to block malaria transmission, to define the roadblocks to the use of primaquine in Africa and to develop a roadmap to enable its rapid, safe and effective deployment. The output of this meeting is a strategic plan to optimize trial design to reach desired goals efficiently. The roadmap includes suggestions for a series of phase 1, 2, 3 and 4 studies to address specific hurdles to primaquines deployment. These include ex-vivo studies on efficacy, primaquine pharmacokinetics and pharmacodynamics and dose escalation studies for safety in high-risk groups. Phase 3 community trials are proposed, along with Phase 4 studies to evaluate safety, particularly in pregnancy, through pharmacovigilance in areas where primaquine is already deployed. In parallel, efforts need to be made to address issues in drug supply and regulation, to map G6PD deficiency and to support the evaluation of alternative gametocytocidal compounds.

KW - 8-aminoquinoline

KW - Africa

KW - G6PD

KW - Gametocyte

KW - Glucose-6-phosphate dehydrogenase deficiency

KW - Malaria

KW - Plasmodium falciparum

KW - Primaquine

KW - Transmission

UR - http://www.scopus.com/inward/record.url?scp=84867900297&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867900297&partnerID=8YFLogxK

U2 - 10.1186/1475-2875-11-360

DO - 10.1186/1475-2875-11-360

M3 - Article

C2 - 23130957

AN - SCOPUS:84867900297

VL - 11

JO - Malaria Journal

JF - Malaria Journal

SN - 1475-2875

M1 - 360

ER -