QUESTION

Which drug should be given to a p.vivax malaria patient with deficient glucose 6-phosphate for prevention of relapse?

ANSWER

Unfortunately, primaquine is the only drug that is known to kill the latent liver stages of P. vivax and P. ovale. Since it can induce haemolysis in people with G6DP deficiency, this drug is usually not recommended for people with this deficiency. However, there are actually gradations of severity of G6DP deficiency, and so in some cases, primaquine at therapeutic doses may be tolerated by people with only mild G6DP deficiency, if they are carefully monitored for anaemia throughout the process. This may be preferable to no treatment, since no other known medication can prevent relapse.