DHA-PPQ vs CHQ With Tafenoquine for P. Vivax Mono-infection
Status:
Not yet recruiting
Trial end date:
2025-08-31
Target enrollment:
Participant gender:
Summary
In this area of Greater Mekong Subregion (GMS), vivax malaria is the most common kind of
malaria. It can stay very long in the liver, and come out later to make another episode of
illness. This can happen many times even without a mosquito bite. Only 8-aminoquinoline drugs
can kill the liver forms of the malaria parasite. One of these drugs is called primaquine,
and it has been used all over the world for a long time. There is now a new formulation of
this 8-aminoquinoline drug called tafenoquine that can also treat the malaria in the liver.
The main benefit of this drug is that it is a single dose, which makes much convenient for
the patients as well as for the malaria control program than conventional 14 days of
primaquine. Recent research suggests that ACT (Artemisinin Combination Therapy) may
antagonise the efficacy of tafenoquine (Baird et al. 2020) . This could prevent the use of
tafenoquine in areas with chloroquine resistant P. vivax parasites where national malaria
programmes recommend ACTs for vivax malaria. Also, currently recommended tafenoquine dose is
sub-optimal: 300 mg dose proved significantly inferior to low dose primaquine in a
meta-analysis of the phase 3 studies when restricted to the Southeast Asian region
(Llanos-Cuentas et al. 2019; Watson et al. 2022). A tafenoquine dose of 450mg is predicted to
provide >90% of the maximal effect. The objective of this research is to find out whether 450
mg dose of tafenoquine can be combined effectively with ACT providing a short course
treatment for P. vivax malaria.