Malaria causes illness or death in unprotected travelers. Primaquine prevents malaria by attacking liver-stage parasites, a property distinguishing it from most chemoprophylactics and obviating 4-week postexposure dosing. A daily adult regimen of 30 mg primaquine prevented malaria caused by Plasmodium falciparum and P. vivax for 20 weeks in 95 of 97 glucose-6-phosphate dehydrogenase (G6PD)-normal Javanese transmigrants in Papua, Indonesia. In comparison, 37 of 149 subjects taking placebo in a parallel trial became parasitemic. The protective efficacy of primaquine against malaria was 93% (95% confidence interval [CI] 71%-98%); against P. falciparum it was 88% (95% CI 48%-97%), and >92% for P. vivax (95% CI >37%-99%). Primaquine was as well tolerated as placebo. Mild methemoglobinemia (mean of 3.4%) returned to normal within 2 weeks. Blood chemistry and hematological parameters revealed no evidence of toxicity. Good safety, tolerance, and efficacy, along with key advantages in dosing requirements, make primaquine an excellent drug for preventing malaria in nonpregnant, G6PD-normal travelers.

译文

疟疾导致未受保护的旅行者生病或死亡。Primaquine通过攻击肝期寄生虫来预防疟疾,这种特性使其与大多数化学预防药物区分开来,并避免了暴露后4周的剂量。每天服用30 mg伯喹的成人方案可预防由恶性疟原虫和间日疟原虫引起的疟疾,持续20周,在印度尼西亚巴布亚的97种葡萄糖-6-磷酸脱氢酶 (G6PD) 正常爪哇人转运中,有95种。相比之下,在平行试验中服用安慰剂的149名受试者中有37名成为寄生虫。93% 了primaquine对疟疾的保护作用 (95% 置信区间 [CI] 71%-98%); 对恶性疟原虫的保护作用是88% 的 (95% CI 48%-97%),并且> 92% 对间日疟原虫 (95% CI >37%-99%)。伯喹的耐受性与安慰剂一样好。轻度高铁血红蛋白血症 (平均3.4%) 在2周内恢复正常。血液化学和血液学参数未显示毒性证据。良好的安全性,耐受性和有效性,以及在剂量要求方面的关键优势,使primaquine成为预防非孕妇,G6PD-normal旅行者疟疾的出色药物。

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