{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T01:40:30Z","timestamp":1781746830034,"version":"3.54.5"},"reference-count":57,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,9]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Plasmodium vivax<\/jats:italic> malaria elimination requires radical cure with chloroquine\/primaquine. However, primaquine causes hemolysis in glucose-6-phosphate dehydrogenase-deficient (G6PDd) individuals. Between February 2016 and July 2017 in Odisha State, India, a prospective, observational, active pharmacovigilance study assessed the hematologic safety of directly observed 25 mg\/kg chloroquine over 3 days plus primaquine 0.25 mg\/kg\/day for 14 days in 100 <jats:italic>P. vivax<\/jats:italic> patients (\u2265 1 year old) with hemoglobin (Hb) \u2265 7 g\/dL. Pretreatment G6PDd screening was not done, but patients were advised on hemolysis signs and symptoms using a visual aid. For evaluable patients, the mean absolute change in Hb between day 0 and day 7 was \u22120.62 g\/dL (95% confidence interval [CI]: \u22120.93, \u22120.31) for males (<jats:italic>N<\/jats:italic> = 53) versus \u22120.24 g\/dL (95%CI: \u22120.59, 0.10) for females (<jats:italic>N<\/jats:italic> = 45; <jats:italic>P<\/jats:italic> = 0.034). Hemoglobin declines \u2265 3 g\/dL occurred in 5\/99 (5.1%) patients (three males, two females); none had concurrent clinical symptoms of hemolysis. Based on G6PD qualitative testing after study completion, three had a G6PD-normal phenotype, one female was confirmed by genotyping as G6PDd heterozygous, and one male had an unknown phenotype. A G6PDd prevalence survey was conducted between August 2017 and March 2018 in the same region using qualitative G6PD testing, confirmed by genotyping. G6PDd prevalence was 12.0% (14\/117) in tribal versus 3.1% (16\/509) in nontribal populations, with G6PD Orissa identified in 29\/30 (96.7%) of G6PDd samples. Following chloroquine\/primaquine, notable Hb declines were observed in this population that were not recognized by patients based on clinical signs and symptoms.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0816","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T07:43:37Z","timestamp":1641800617000},"page":"831-840","source":"Crossref","is-referenced-by-count":3,"title":["Active Pharmacovigilance for Primaquine Radical Cure of Plasmodium vivax Malaria in Odisha, India"],"prefix":"10.4269","volume":"106","author":[{"given":"Anupkumar R.","family":"Anvikar","sequence":"first","affiliation":[{"name":"National Institute of Malaria Research, Dwarka, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prajyoti","family":"Sahu","sequence":"additional","affiliation":[{"name":"National Vector Borne Disease Control Programme (NVBDCP), Odisha, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madan M.","family":"Pradhan","sequence":"additional","affiliation":[{"name":"National Vector Borne Disease Control Programme (NVBDCP), Odisha, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriya","family":"Sharma","sequence":"additional","affiliation":[{"name":"National Institute of Malaria Research, Dwarka, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naseem","family":"Ahmed","sequence":"additional","affiliation":[{"name":"National Institute of Malaria Research, Dwarka, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chander P.","family":"Yadav","sequence":"additional","affiliation":[{"name":"National Institute of Malaria Research, Dwarka, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreya","family":"Pradhan","sequence":"additional","affiliation":[{"name":"National Vector Borne Disease Control Programme (NVBDCP), Odisha, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Duparc","sequence":"additional","affiliation":[{"name":"Medicines for Malaria Venture, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny","family":"Grewal Daumerie","sequence":"additional","affiliation":[{"name":"Medicines for Malaria Venture, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neena","family":"Valecha","sequence":"additional","affiliation":[{"name":"National Institute of Malaria Research, Dwarka, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"World Malaria Report","year":"2020"},{"key":"b2","series-title":"Indian J Med Res","first-page":"123","article-title":"Eliminating malaria in India by 2027: the countdown begins!","volume":"148","year":"2018"},{"key":"b3","year":"2016"},{"key":"b4","year":"2015"},{"key":"b5","series-title":"Wellcome Open Res","first-page":"21","article-title":"Optimizing G6PD testing for Plasmodium vivax case management and beyond: why sex, counseling, and community engagement matter","volume":"5","year":"2020"},{"key":"b6","series-title":"Malar J","first-page":"101","article-title":"Primaquine-induced haemolysis in females heterozygous for G6PD deficiency","volume":"17","year":"2018"},{"key":"b7","series-title":"Wellcome Open Res","first-page":"25","article-title":"The impact of using primaquine without prior G6PD testing: a case series describing the obstacles to the medical management of haemolysis","volume":"4","year":"2019"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"702","article-title":"Hemolytic potential of tafenoquine in female volunteers heterozygous for glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PD Mahidol variant) versus G6PD-normal volunteers","volume":"97","year":"2017"},{"key":"b9","series-title":"Blood","first-page":"103","article-title":"The hemolytic effect of primaquine and related compounds: a review","volume":"14","year":"1959"},{"key":"b10","series-title":"Blood","first-page":"961","article-title":"Genetics of red cells and susceptibility to malaria","volume":"54","year":"1979"},{"key":"b11","series-title":"Science","first-page":"442","article-title":"Malaria. 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