Doses of primaquine administered to children with Plasmodium vivax according to an age-based dose regimen

Michelle Valeria Dias Ferreira Vieira, Tamyris Regina Matos Lopes, Amanda Gabryelle Nunes Cardoso Mello, Luann Wendel Pereira de Sena, Robert J. Commons, José Luiz Fernandes Vieira

    Research output: Contribution to journalArticle

    Abstract

    Primaquine is still the first-line drug to eliminate hypnozoites of Plasmodium vivax. The therapeutic efficacy is related to the total dose administered. In several endemic areas, the drug is administered for children in an age-based regimen, which can lead to inadequate exposure, increasing the rates of recurrence of the infection. The present study aims to describe the mg/kg total dose of primaquine administered to children for treatment for vivax malaria when an age-based regimen is used and to measure the plasma concentrations of primaquine and carboxyprimaquine. A total of 85 children were included in the study. The total dose of primaquine administered based on mg/kg had a median value of 3.22 mg/kg. The percentage of patients with a total dose below the required dose of 3.5 mg/kg was 55.75%. The median primaquine maximum concentration was 94 ng/ml. For carboxy-primaquine, the median maximum concentration was 375 ng/ml. The results suggest that age-based dosing regimens likely lead to substantial under-dosing of primaquine, which is evident in the youngest children and is reflected in decreased levels of primaquine and carboxy-primaquine in plasma samples.

    Original languageEnglish
    JournalPathogens and Global Health
    DOIs
    Publication statusE-pub ahead of print - 24 Jul 2020

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    Vieira, M. V. D. F., Matos Lopes, T. R., Mello, A. G. N. C., de Sena, L. W. P., Commons, R. J., & Vieira, J. L. F. (2020). Doses of primaquine administered to children with Plasmodium vivax according to an age-based dose regimen. Pathogens and Global Health. https://doi.org/10.1080/20477724.2020.1799166