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Primaquine resistance in Plasmodium vivax
1Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
The American Journal of Tropical Medicine and Hygiene
|September 1, 1996
Summary
Primaquine resistance in Plasmodium vivax is a growing concern. While direct evidence is limited, monitoring relapses after primaquine therapy is crucial for early detection of emerging resistance.
Area of Science:
- Malariology
- Drug Resistance Studies
- Infectious Diseases
Background:
- Primaquine resistance in Plasmodium vivax has been reported in several regions.
- Widespread population mobility may have disseminated primaquine-tolerant strains globally.
- Emergence of 4-aminoquinoline-resistant P. vivax strains complicates the resistance landscape.
Purpose of the Study:
- To review the current understanding of primaquine resistance in Plasmodium vivax.
- To highlight the challenges in detecting and confirming primaquine resistance.
- To emphasize the importance of monitoring P. vivax relapses and primaquine's activity.
Main Methods:
- Review of existing literature on primaquine resistance in P. vivax.
- Analysis of reports on P. vivax relapses following primaquine treatment.
- Evaluation of data on the sporontocidal and gametocytocidal activity of primaquine.
Main Results:
- Limited direct evidence of acquired primaquine resistance in P. vivax currently exists.
- Primaquine-tolerant strains, particularly from Southeast Asia and the South Pacific, are a concern.
- Relapses after primaquine therapy are considered the most reliable indicator of resistance.
Conclusions:
- The emergence of primaquine resistance in P. vivax is a potential future threat.
- Timely detection and confirmation of resistance are critical but challenging.
- Establishing baselines for primaquine's activity against P. vivax is essential for monitoring resistance.
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