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Prophylactic Efficacy of Primaquine for Preventing Plasmodium Falciparum and Plasmodium Vivax Parasitaemia in Travelers: A Meta-Analysis and Systematic Review Publisher Pubmed



Kolifarhood G1 ; Raeisi A2 ; Ranjbar M3 ; Haghdoust AA4 ; Schapira A5 ; Hashemi S6 ; Masoumiasl H7 ; Mozafar Saadati H1 ; Azimi S1 ; Khosravi N8 ; Kondrashin A9
Authors
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Authors Affiliations
  1. 1. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Center for Vectors and Vector-Borne Diseases and Department of Biology, Mahidol University, Bangkok, Thailand
  4. 4. Department of Epidemiology and Biostatistics, School of Health, Kerman University of Medical Sciences, Kerman, Iran
  5. 5. Independent consultant, Legazpi City, Philippines
  6. 6. Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
  8. 8. Department of Community Health Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
  9. 9. Sechenov First Moscow State Medical University, Moscow, Russian Federation

Source: Travel Medicine and Infectious Disease Published:2017


Abstract

Background With increased international travel over the world the need for safe and effective chemoprophylaxis for malaria is as great as ever. The choice of regimen is difficult, as effectiveness should be weighted against potential adverse effects. Although, some studies have reported high prophylactic efficacy of primaquine, there is no comprehensive evidence comparing its prophylactic effectiveness as well as toxicity. To fill the gap, this systematic review and meta-analysis study was carried out. Methods Using MeSH terms, 756 records were detected through searching “Pubmed”, “Embase”,”Web of Science”and “Cochrane” databases. From these,7 relevant full-text articles with 14 comparisons for final quantitative meta-analysis were included in our review. In order to make a comparison between the studies, Risk Ratios(RRs) and their 95% confidence intervals(CIs) were estimated. Results Overall,74% reduction in the incidence of parasitaemia by primaquine versus other prophylactic regimens was estimated(RRoverall = 0.26, CI 95%:0.16–0.41–RRvivax = 0.16, CI 95%:0.07–0.36–RRfalciparum = 0.31, CI 95%:0.18–0.55). The incidence rate ratios for adverse effects showed no statistically significant difference between primaquine and control groups (p > 0.05). Conclusions For persons without G6PD deficiency, who are not pregnant, primaquine is the most effective presently available prophylactic for P. vivax malaria and comparable to such regimens as doxycycline, mefloquine and atovaquone-proguanil for the prevention of P. falciparum malaria. © 2017 Elsevier Ltd
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