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Am. J. Trop. Med. Hyg., 76(3), 2007, pp. 494-496
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


TAFENOQUINE FOR THE TREATMENT OF RECURRENT PLASMODIUM VIVAX MALARIA

SCOTT KITCHENER*, PETER NASVELD, AND MICHAEL D. EDSTEIN
Centre for Military and Veterans Health, University of Queensland, Herston, Queensland, Australia (formerly of Australian Army Malaria Institute); Australian Army Malaria Institute, Gallipoli Barracks, Enoggera, Queensland, Australia

 

ABSTRACT

Tafenoquine was used to treat Plasmodium vivax malaria cases who had previously failed treatment with chloroquine and primaquine. Chloroquine was followed by a loading dose of tafenoquine (200 mg base/day for 3 days) and 200 mg a week was given for 8 weeks. One of 27 treated patients relapsed after 6 months of observation. A standard course of chloroquine administered with 8 weeks of tafenoquine may be more effective than chloroquine with primaquine (22.5 mg/day for 14 days) in preventing additional P. vivax relapses. Larger studies are required to optimize the combination, but our findings suggest that an extended use of tafenoquine may be required to prevent relapses of primaquine-tolerant strains of P. vivax malaria.

Received September 25, 2006. Accepted for publication November 21, 2006.

Acknowledgments: We thank the Australian Defence Force personnel for participating in this study and GlaxoSmithKline for providing the medication. We also thank Captain Alyson Auliff for confirming the blood smears for P. vivax malaria, Wayne Lyons for measuring the plasma tafenoquine concentrations, Professor Dennis Shanks for advise on the schedule used in this clinical trial, and Drs. J. Simpson, P. Zarifa, D. Ward, M. Graves, I. Seidl, and J Graff for their medical support during the study. Disclaimer: The opinions expressed are those of the authors and do not necessarily reflect those of the Defence Health Service or any extant ADF policy. Other than provision of medication, the study described within was wholly conducted using the resources and personnel of the ADF.

Disclosure: All authors were full time members of the Australian Defence Force at the time of the study, posted to the Australian Army Malaria Institute. The authors have received funding for travel to present results of related tafenoquine studies from the sponsor (GlaxoSmithKline) of this study. They have no other potential conflicts of interest concerning the work reported in this paper.

* Address correspondence to Scott Kitchener, Centre for Military and Veterans Health, University of Queensland, Mayne Medical School Building, Herston Road, Herston 4006, Queensland, Australia. E-mail: s.kitchener{at}uq.edu.au

Authors’ addresses: Scott Kitchener and Peter Nasveld, Centre for Military and Veterans Health, University of Queensland, Mayne Medical School Building, Herston Road, Herston 4006, Queensland, Australia, Telephone: 61-7-3346-4902 and 61-7-3346-4876, Fax: 61-7-3346-4878, E-mails: s.kitchener{at}uq.edu.au and p.nasveld{at}uq.edu.au. Michael D. Edstein, Army Malaria Institute, Gallipoli Barracks, Enoggera, Brisbane 4051, Queensland, Australia, Telephone: 61-7-3332-4800, Fax: 61-7-3332-4801, E-mail: mike.edstein{at}defence.gov.au.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.