Remarks

• Without testing for G6PD deficiency, the GDG noted the potential for severe harm from the use of a therapeutic dose of an 8-aminoquinoline for radical cure of P. vivax hypnozoites. However, conducting G6PD testing for a large population would significantly add to the complexity and cost of the intervention.
• The GDG noted that there may be highly exceptional circumstances under which mass relapse prevention (MRP) may be appropriate, such as during a small focal outbreak of P. vivax in a temperate area. However, under such circumstances the GDG considered that an MDA programme providing a schizonticide in addition to an 8-aminoquinoline would likely be a better strategy.