Biology Reference
In-Depth Information
Table 4.1
Evolution of Therapies for Vivax Malaria
Treatment
Developed
Discontinued
Advantage
Disadvantage
QN
1600s
1940s
Cures acute
attack
- No effect on relapse
- Side effects
- Lengthy dosing
QN + PM
1924
1942
Achieves
radical
cure
- Dangerous toxicity
of PM
AB + PM
1942
1943
Achieves
radical
cure
- AB-PM interaction
exacerbates already
dangerous PM
toxicity
CQ + PQ
1950
Still in use
Achieves
radical
cure
- PQ toxicity in
G6PDd
- Lengthy PQ dosing
- Resistance to CQ
ACT + PQ 2000s
In limited use
Cures CQ-
resistant
acute
attack
- PQ safety/efficacy
- Lengthy PQ dosing
- Most ACTs
unproven with PQ
CQ + TQ
In phase
IIb trials
in 2012
Not yet in
use
Achieves
radical
cure with
brief dos-
ing
- TQ also toxic in
G6PDd
- CQ resistance
QN = quinine; PM = Pamaquine; AB = atabrine; CQ = chloroquine; PQ = primaquine;
TQ tafenoquine.
tissue stages by concurrent administration of quinine, therefore, still remains a mat-
ter of uncertainty
'. They designed and executed a clinical trial to address that
uncertainty.
After following an elaborate protocol aimed at minimizing variance in
the numbers of sporozoites inoculated via mosquito biting, 57 volunteers
were randomized to three treatment groups of 19 men each. Two groups
received identical 14-day doses of quinine and primaquine, one concur-
rently and the other quinine first followed by primaquine after a two-day
pause. The third treatment group received chloroquine rather than quinine,
