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Repeated Plasmodium vivax malaria relapses in a Peruvian sailor
Adam P McFarland1, Juan F Sanchez2, Alejandro Mercado3
1School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA. mcfarlaa@gmail.com.
Malaria Journal
|December 2, 2015
Summary
Two Plasmodium vivax relapses occurred in a sailor weighing over 60 kg, emphasizing the need for correct weight-based dosing of primaquine for radical cure. This is crucial for effective patient treatment and malaria control, especially in military settings.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Parasitology
Background:
- Plasmodium vivax is a leading cause of malaria recurrence due to dormant liver stages (hypnozoites).
- Radical cure, typically involving primaquine, targets these hypnozoites to prevent relapse.
- Primaquine dosage guidelines often have weight-based caps, potentially affecting efficacy in heavier individuals.
Observation:
- A Peruvian sailor experienced two P. vivax recurrences.
- The sailor's weight exceeded the 60 kg threshold, a common cap for standard primaquine dosing.
Findings:
- The recurrences suggest that the capped primaquine dosage may have been insufficient for radical cure in this heavier individual.
- This highlights a potential gap in current dosing recommendations for P. vivax radical cure in patients above the weight cap.
Implications:
- Optimizing weight-based primaquine dosing is essential for preventing P. vivax relapses and improving treatment outcomes.
- Accurate dosing strategies are critical for malaria control programs, particularly in populations like the military where P. vivax prevalence can be significant.
- Further research is needed to refine primaquine dosage guidelines for individuals exceeding standard weight caps.
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