HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Carmona-Fonseca, J. Articles by Maestre, A. Search for Related Content PubMed PubMed Citation Articles by Carmona-Fonseca, J. Articles by Maestre, A. Related Collections Malaria

Methemoglobinemia and Adverse Events in Plasmodium vivax Malaria Patients Associated with High Doses of Primaquine Treatment

Primaquine (PQ) is recommended to prevent relapses in patients with Plasmodium vivax malaria infection. However, treatment with PQ causes methemoglobinemia. In this study, we measured the methemoglobin (MetHB) levels in three groups of subjects who received PQ treatment at 0.58, 0.83, or 1.17 mg/kg/d. A total of 112 subjects were studied. MetHB levels were detected at 4% in 46–50% 1 day after PQ treatment in all three groups and 4–9% of subjects had MetHB levels 4% 15 days after treatment. Only subjects receiving the highest doses of PQ had mild and brief adverse events, and 17% of them were associated with treatment. We conclude that when PQ is administered under certain conditions (i.e., normal glucose-6-phosphate dehydrogenase activity, in non-pregnant subjects and with a light meal), daily doses as high as 1.17 mg/kg do not represent a serious risk of high MetHB levels to patients.

Received December 5, 2007. Accepted for publication August 20, 2008.

Acknowledgments: The authors thank the directors of the local hospitals at Turbo and El Bagre for support, the volunteers for collaboration, the Grupo Malaria personnel in the field for technical support, and Dr. Roubing Wang for reviewing the manuscript.

Financial support: This work was supported by Universidad de Antioquia, Colciencias (Code 1115-04-16497; contract RC-253-20043) and Dirección Seccional de Salud de Antioquia (DSSA).

^* Address correspondence to Amanda Maestre, Grupo Grupo Salud y Comunidad, Universidad de Antioquia, Calle 62 # 52–59, Medellín, Colombia. E-mail: aemaestre{at}quimbaya.udea.edu.co

Authors’ addresses: Jaime Carmona-Fonseca and Amanda Maestre, Grupo Grupo Salud y Comunidad, Universidad de Antioquia, Calle 62 # 52–59, Medellín, Colombia, Tel: 57-4-2196000, Fax: 57-4-2196487. Gonzalo Álvarez, Grupo Malaria Universidad de Antioquia, Calle 62 # 52–59, Medellín, Colombia, Tel: 57-4-2196486, Fax: 57-4-2196487.

Reprint requests: Amanda Maestre, Universidad de Antioquia, Calle 62 # 52–59, Medellín, Colombia. E-mail: aemaestre{at}quimbaya.udea.edu.co.