Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Rue de Flamboyants, 97300, Cayenne, French Guiana.
Ecosystèmes Amazoniens et Pathologie Tropicale (EPAT), EA 3593, Université de Guyane, Cayenne, French Guiana.
Malar J. 2018 Jun 19;17(1):237. doi: 10.1186/s12936-018-2378-2.
The preventive treatment of Plasmodium vivax relapse recommended by the World Health Organization is primaquine at a dose of 15 mg/day for 14 days, except for malaria cases from Asia and Oceania. Since 2006, CDC recommends the use of primaquine at 30 mg/day for 14 days. In France, all cases of malaria due to P. vivax are treated with 30 mg of primaquine. This systematically increased dosage needs to be evaluated according to epidemiological context. The aim of the study was to compare relapses after 14 days of primaquine at 15 or 30 mg/day.
All patients treated with primaquine after a vivax malaria episode in French Guiana, between 1 January, 2007 and 1 August, 2016, were studied. Based on the compulsory hospital pharmacy forms for primaquine delivery, adult patients who received 15 or 30 mg of primaquine during 14 days for hypnozoite eradication were included. The recommended dose was initially 15 mg and was changed to 30 mg in 2011. Vivax malaria recurrences within 2 months after primaquine treatment, and vivax malaria recurrences 2-6 months after primaquine in each treatment group were analysed using survival analysis at 2, 3 and 6 months.
Out of 544 patients included, 283 received 15 mg/day and 261 received 30 mg/day of primaquine. At 2 and 3 months after primaquine treatment, the number of recurrences was 7 (2.5%) and 19 (7.3%), and 9 (3.4%) and 15 (5.3%), in the 15 and 30 mg groups (p = 0.51 respectively 0.35), respectively. Within 3 months, the median time to recurrence was 2.05 months in the 15 and 30 mg groups. At 6 months after primaquine treatment, the number of recurrences was 25 (8.8%) and 31 (11.9%) at 15 and 30 mg, respectively (p = 0.24). The median time to recurrence was 2.38 months at 15 mg/day and of 2.64 months at 30 mg/day.
There were no significant differences between primaquine at 15 or 30 mg/day for 14 days in the prevention of P. vivax relapses at 2, 3 and 6 months after primaquine treatment in French Guiana.
世界卫生组织推荐的预防间日疟原虫复发的治疗方法是 15 毫克/天的伯氨喹治疗 14 天，但亚洲和大洋洲的疟疾病例外。自 2006 年以来，CDC 建议使用 30 毫克/天的伯氨喹治疗 14 天。在法国，所有因间日疟原虫引起的疟疾病例均使用 30 毫克的伯氨喹进行治疗。这种系统增加的剂量需要根据流行病学情况进行评估。本研究的目的是比较 15 或 30 毫克/天的伯氨喹治疗 14 天后的复发情况。
本研究纳入了 2007 年 1 月 1 日至 2016 年 8 月 1 日期间在法属圭亚那因间日疟原虫感染而接受伯氨喹治疗的所有患者。基于伯氨喹配送的强制性医院药房表格，纳入了在 14 天内接受 15 或 30 毫克伯氨喹以消除休眠疟原虫的成年患者。推荐剂量最初为 15 毫克，2011 年改为 30 毫克。采用生存分析方法，在治疗后 2、3 和 6 个月分别分析治疗组中 2 个月内和 2-6 个月内的间日疟复发情况。
本研究共纳入 544 例患者，其中 283 例患者接受了 15 毫克/天的伯氨喹治疗，261 例患者接受了 30 毫克/天的伯氨喹治疗。在伯氨喹治疗后 2 和 3 个月时，15 和 30 毫克组的复发率分别为 7（2.5%）和 19（7.3%）（p=0.51），9（3.4%）和 15（5.3%）（p=0.35）。在 3 个月内，15 和 30 毫克组的中位复发时间分别为 2.05 个月。在伯氨喹治疗后 6 个月时，15 和 30 毫克组的复发率分别为 25（8.8%）和 31（11.9%）（p=0.24）。15 毫克/天组的中位复发时间为 2.38 个月，30 毫克/天组的中位复发时间为 2.64 个月。
在法属圭亚那，15 或 30 毫克/天的伯氨喹治疗 14 天，在伯氨喹治疗后 2、3 和 6 个月时预防间日疟原虫复发方面没有显著差异。
