Malaria chemoprophylaxis in the age of drug resistance. II. Drugs that may be available in the future

Shanks G.D., Kain K.C. and Keystone J.S. (2001) Malaria chemoprophylaxis in the age of drug resistance. II. Drugs that may be available in the future. Clinical Infectious Diseases, 33 3: 381-385. doi:10.1086/321866


Author Shanks G.D.
Kain K.C.
Keystone J.S.
Title Malaria chemoprophylaxis in the age of drug resistance. II. Drugs that may be available in the future
Journal name Clinical Infectious Diseases   Check publisher's open access policy
ISSN 1058-4838
Publication date 2001-01-01
Year available 2001
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1086/321866
Open Access Status Not yet assessed
Volume 33
Issue 3
Start page 381
End page 385
Total pages 5
Place of publication CHICAGO
Publisher UNIV CHICAGO PRESS
Language eng
Subject 2403 Immunology
Abstract All current regimens of malaria chemoprophylaxis have serious drawbacks as a result of either suboptimal efficacy, difficulty with medication compliance, or adverse events. Two 8-aminoquinolines may be approaching registration, with primaquine having completed its prophylactic field testing and tafenoquine having begun advanced field testing at the end of 2000. Primaquine has long been used for management of relapses of malaria, but in the past decade, it has been reexamined for use in malaria prevention in order to stop infection in the liver. In field trials performed in Indonesia and Colombia, the efficacy of primaquine for malaria prevention was similar to 90%, compared with that of placebo. Because of its short half-life, primaquine requires daily administration. For adults, the prevention regimen is 30 mg base daily (0.5 mg base/kg/day), and it can probably be discontinued soon after departure from an area where malaria is endemic. To kill parasites that already exist in the liver, terminal prophylaxis is given after exposure to relapses of malaria infection; for adults, such prophylaxis usually consists of 15 mg base (0.3 mg base/kg/day) given daily for 2 weeks. Primaquine-induced gastrointestinal disturbances can be minimized if the drug is taken with food. Neither primaquine nor tafenoquine should be given to persons with glucose-6-phosphate dehydrogenase deficiency, to avoid the development of potentially severe drug-induced hemolysis. Tafenoquine is an analogue of primaquine that is more potent than the parent drug. Field trials in Kenya, Ghana, Gabon, and Southeast Asia have demonstrated an efficacy rate of similar to 90% for tafenoquine. Its long half-life allows for infrequent dosing (currently tested at 200 mg base/week), and its effect on parasites at the liver stage may allow for drug discontinuation at the time of departure from the area of endemicity.
Keyword Immunology
Infectious Diseases
Microbiology
Immunology
Infectious Diseases
Microbiology
IMMUNOLOGY
INFECTIOUS DISEASES
MICROBIOLOGY
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: Scopus Import - Archived
 
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