ricprice99.bsky.social
Global Health | Infectious Diseases | Physician practising in the tropical north of Australia | Clinical Researcher
#IDSky #malaria #vivax
https://www.menzies.edu.au/page/Our_People/Researchers/Ric_Price
31 posts
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Prolific Poster
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Still no change in recommendation to not use primaquine in lactating women, despite study in Thailand showing minimal exposure to infant after 28 days. This effectively excludes a high proportion of females of child bearing age from radical cure
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Tafenoquine now recommened in patients >2yrs of age with >70% G6PD activity. Restricted to coadmin with Chloroquine cos of concerns of DDI with ACT. Recommendations focused on South America, but data from Africa and Asia-Pacific is accuring
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High dose primaquine (7mg/kg) recommended over 3.5mg/kg. Administered over 14 days (0.5mg/kg/day) or 7 days (1mg/kg/day). PQ7 potentially better compliance but more GI adverse events, and only recommended in patients with >70% G6PD activity (ie needs semiquant G6PD testing)
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Adults usually get same dose of antimalarials irrespective of their weight. In this study dose was adjusted for weight and still suboptimal
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Also highlights the utility of novel serology tests to identify hypnozoite carriers when transmission intensity falls below 0.5 infections per year
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High rate of physicians declining enrolment suggests more complicated cases may have been excluded even after restrictive inclusion criteria