Cochrane · systematic review · CD008152

Primaquine or other 8‐aminoquinolines for reducing Plasmodium falciparum transmission

Graves, PM, Choi, L, Gelband, H, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Infectious Diseases4 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
20
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 1 · 4.8%Very low 2 · 9.5%Low 9 · 42.9%Moderate 6 · 28.6%High 3 · 14.3%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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Single dose primaquine at 0.2 to 0.25 mg/kg compared to no primaquine, with artemisinin partner, for reducing P. falciparum transmission

Population: adults and children with malaria being treated with artemisinin combination treatment
5 questions
OutcomeEffectEvidenceStatus / GRADE
Participants infectious at day 3‐4
Single dose primaquine at 0.2 to 0.25 mg/kg vs no primaquine, with artemisinin partner,
RR 0.12 [0.02, 0.88]3 studies · 105 participantsLow
Downgraded: imprecision
Participants infectious at day 8
Single dose primaquine at 0.2 to 0.25 mg/kg vs no primaquine, with artemisinin partner,
RR 0.34 [0.07, 1.58]4 studies · 243 participantsLow
Downgraded: imprecision
Participants with gametocytes at day 3 to 4 by PCR
Single dose primaquine at 0.2 to 0.25 mg/kg vs no primaquine, with artemisinin partner,
RR 1.02 [0.87, 1.21]3 studies · 414 participantsModerate
Downgraded: imprecision
Participants with gametocytes at day 8 by PCR
Single dose primaquine at 0.2 to 0.25 mg/kg vs no primaquine, with artemisinin partner,
RR 0.52 [0.41, 0.65]4 studies · 532 participantsHigh
Participants with severe haemolysis
Single dose primaquine at 0.2 to 0.25 mg/kg vs no primaquine, with artemisinin partner,
RR 0.98 [0.69, 1.39]4 studies · 752 participantsModerate
Downgraded: imprecision

Single dose primaquine at 0.4 to 0.5 mg/kg compared to no primaquine, with artemisinin partner, for reducing P. falciparum transmission

Population: adults and children with malaria being treated with artemisinin combination treatment
5 questions
OutcomeEffectEvidenceStatus / GRADE
Participants infectious at day 3‐4
Single dose primaquine at 0.4 to 0.5 mg/kg vs no primaquine, with artemisinin partner,
RR 0.13 [0.02, 0.94]3 studies · 109 participantsLow
Downgraded: imprecision
Participants infectious at day 8
Single dose primaquine at 0.4 to 0.5 mg/kg vs no primaquine, with artemisinin partner,
RR 0.33 [0.07, 1.57]4 studies · 246 participantsLow
Downgraded: imprecision
Participants with gametocytes at day 3‐4, by PCR
Single dose primaquine at 0.4 to 0.5 mg/kg vs no primaquine, with artemisinin partner,
RR 1.09 [0.93, 1.28]3 studies · 418 participantsModerate
Downgraded: imprecision
Participants with gametocytes at day 8, by PCR
Single dose primaquine at 0.4 to 0.5 mg/kg vs no primaquine, with artemisinin partner,
RR 0.37 [0.29, 0.48]5 studies · 758 participantsHigh
Participants with severe haemolysis
Single dose primaquine at 0.4 to 0.5 mg/kg vs no primaquine, with artemisinin partner,
RR 1.54 [0.38, 6.3]2 studies · 260 participantsLow
Downgraded: imprecision

Single dose primaquine at 0.75 mg/kg compared to no primaquine, with artemisinin partner, for reducing P. falciparum transmission

Population: adults and children with malaria being treated with artemisinin combination treatment
5 questions
OutcomeEffectEvidenceStatus / GRADE
Participants infectious at day 3‐4
Single dose primaquine at 0.75 mg/kg vs no primaquine, with artemisinin partner,
RR 0.2 [0.02, 1.68]1 study · 101 participantsLow
Downgraded: imprecision
Participants infectious at day 8
Single dose primaquine at 0.75 mg/kg vs no primaquine, with artemisinin partner,
RR 0.18 [0.02, 1.41]2 studies · 181 participantsLow
Downgraded: imprecision
Participants with gametocytes at day 3‐4, by PCR
Single dose primaquine at 0.75 mg/kg vs no primaquine, with artemisinin partner,
RR 0.92 [0.75, 1.13]2 studies · 290 participantsLow
Downgraded: imprecision, indirectness
Participants with gametocytes at day 8, by PCR
Single dose primaquine at 0.75 mg/kg vs no primaquine, with artemisinin partner,
RR 0.31 [0.23, 0.43]5 studies · 793 participantsHigh
Participants with severe haemolysis
Single dose primaquine at 0.75 mg/kg vs no primaquine, with artemisinin partner,
no estimate extracted1 study · 106 participantsUngraded

Single dose primaquine at 0.4 to 0.5 mg/kg compared to no primaquine, with non‐artemisinin partner, for reducing P. falciparum transmission

Population: adults and children with malaria being treated with non‐artemisinin treatment
2 questions
OutcomeEffectEvidenceStatus / GRADE
Participants with gametocytes at day 4‐5, by microscopy
Single dose primaquine at 0.4 to 0.5 mg/kg vs no primaquine, with non‐artemisinin partner,
RR 0.83 [0.62, 1.13]2 studies · 221 participantsModerate
Downgraded: indirectness
Participants with gametocytes at day 8, by microscopy
Single dose primaquine at 0.4 to 0.5 mg/kg vs no primaquine, with non‐artemisinin partner,
RR 0.6 [0.49, 0.75]2 studies · 216 participantsModerate
Downgraded: indirectness

Single dose primaquine at 0.75 mg/kg compared to no primaquine, with non‐artemisinin partner, for reducing P. falciparum transmission

Population: adults and children with malaria being treated with non‐artemisinin treatment
4 questions
OutcomeEffectEvidenceStatus / GRADE
Participants infectious at day 5
Single dose primaquine at 0.75 mg/kg vs no primaquine, with non‐artemisinin partner,
RR 0.09 [0.01, 0.62]2 studies · 30 participantsVery low
Downgraded: risk of bias, imprecision
Participants infectious at day 8
Single dose primaquine at 0.75 mg/kg vs no primaquine, with non‐artemisinin partner,
RR 0.07 [0.01, 0.45]2 studies · 30 participantsVery low
Downgraded: risk of bias, imprecision
Participants with gametocytes at day 5, by microscopy
Single dose primaquine at 0.75 mg/kg vs no primaquine, with non‐artemisinin partner,
RR 0.85 [0.48, 1.5]2 studies · 52 participantsLow
Downgraded: risk of bias, imprecision
Participants with gametocytes at day 8, by microscopy
Single dose primaquine at 0.75 mg/kg vs no primaquine, with non‐artemisinin partner,
RR 0.39 [0.25, 0.62]4 studies · 186 participantsModerate
Downgraded: risk of bias