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
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
Current version onlySingle 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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Low 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 participants | Moderate 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 participants | High |
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 participants | Moderate 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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Low 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 participants | Moderate 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 participants | High |
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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Low 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 participants | Low 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 participants | High |
Participants with severe haemolysis Single dose primaquine at 0.75 mg/kg vs no primaquine, with artemisinin partner, | no estimate extracted | 1 study · 106 participants | Ungraded |
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
| Outcome | Effect | Evidence | Status / 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 participants | Moderate 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 participants | Moderate 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
| Outcome | Effect | Evidence | Status / 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 participants | Very 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 participants | Very 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 participants | Low 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 participants | Moderate Downgraded: risk of bias |
Summary of findings table 1
Population: People with symptomatic malaria
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Malaria incidence, prevalence or EIR | no estimate extracted | 0 studies · 0 participants | Ungraded |
People infectious to mosquitoes | no estimate extracted | 0 studies · 0 participants | Ungraded |
Participants with gametocytes on microscopy or PCR1 (day 8) | RR 0.67 [0.44, 1.02] | 1 study · 223 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Mean percent change in haemoglobin10 | no estimate extracted | 1 study · 101 participants | Very low Downgraded: indirectness |
Summary of findings table 2
Population: People with symptomatic malaria
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Malaria incidence, prevalence or EIR | no estimate extracted | 0 studies · 0 participants | Ungraded |
People infectious to mosquitoes (day 8) | RR 0.071 [0.01, 0.45] | 2 studies · 30 participants | Low Downgraded: risk of bias, imprecision |
Participants with gametocytes on microscopy (day 8) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Evidence of haemolysis | no estimate extracted | 0 studies · 6 participants | Ungraded |
Summary of findings table 1
Population: People with symptomatic malaria
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Malaria incidence, prevalence or EIR | no estimate extracted | 0 studies · 0 participants | Ungraded |
People infectious to mosquitoes | no estimate extracted | 0 studies · 0 participants | Ungraded |
Participants with gametocytes on microscopy or PCR1 (day 8) | RR 0.67 [0.44, 1.02] | 1 study · 223 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Mean percent change in haemoglobin10 | no estimate extracted | 1 study · 101 participants | Very low Downgraded: indirectness |
Summary of findings table 2
Population: people with symptomatic malaria
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Malaria incidence, prevalence or EIR | no estimate extracted | 0 studies · 0 participants | Ungraded |
People infectious to mosquitoes (day 8) | RR 0.071 [0.01, 0.45] | 2 studies · 30 participants | Low Downgraded: risk of bias, imprecision |
Participants with gametocytes on microscopy (day 8) | RR 1.76 [0.97, 3.18] | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Evidence of haemolysis | no estimate extracted | 0 studies · 9 participants | Ungraded |
Primaquine for preventing infectiousness with ACT treatments
Population: patients with symptomatic malaria
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Malaria incidence, prevalence or EIR ‐ not measured | no estimate extracted | 0 studies · 0 participants | Ungraded |
People infectious to mosquitoes ‐ not measured | no estimate extracted | 0 studies · 0 participants | Ungraded |
Gametocytaemia Log(10) area under curve of density over time. Scale from: 0 to 100. | no estimate extracted | 2 studies · 907 participants | Moderate Downgraded: imprecision |
Participants with gametocytes Microscopy | RR 0.15 [0.09, 0.24] | 4 studies · 1006 participants | Moderate Downgraded: risk of bias, indirectness |
Mean percent change in haemoglobin6 | no estimate extracted | 1 study · 101 participants | Very low Downgraded: imprecision, indirectness |
Primaquine for preventing infectiousness with non‐ACT malaria treatment
Population: patients with symptomatic malaria
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Malaria incidence, prevalence or EIR ‐ not measured | no estimate extracted | NR | No studies |
People infectious to mosquitoes (day 8) | RR 0.05 [0, 0.8] | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision |
Gametocytaemia Log(10) area under curve of density over time. Scale from: 0 to 100. | no estimate extracted | 1 study · 219 participants | Moderate Downgraded: imprecision, indirectness |
Participants with gametocytes Microscopy | RR 0.62 [0.51, 0.76] | 4 studies · 446 participants | Moderate Downgraded: risk of bias, imprecision |
Evidence of haemolysis | no estimate extracted | 0 studies · 0 participants | Ungraded |