Updated Recommendation
A new evidence synthesis was published:2024, WHO guidelines for malaria, 30 November 2024.
View latest version (2024)Bibliographic information
Recommendation
In low-transmission areas, a single dose of 0.25 mg/kg bw primaquine should be given with an ACT to patients with P. falciparum malaria (except pregnant women, infants aged < 6 months and women breastfeeding infants aged < 6 months) to reduce transmission. G6PD testing is not required.
Recommended in favor
Strong
Certainty of evidence
Low
Notes and Remarks
Practical info In light of concern about the safety of the previously recommended dose of 0.75 mg/kg bw in individuals with G6PD deficiency, a WHO panel reviewed the safety of primaquine as a P. falciparum gametocytocide and concluded that a single dose of 0.25 mg/kg bw of primaquine base is unlikely to cause serious toxicity, even in people with G6PD deficiency [211]. Thus, where indicated a single dose of 0.25mg/kg bw of primaquine base should be given on the first day of treatment, in addition to an ACT, to all patients with parasitologically confirmed P. falciparum malaria except for pregnant women, infants < 6 months of age and women breastfeeding infants < 6 months of age, because there are insufficient data on the safety of its use in these groups. Dosing table based on the most widely currently available tablet strength (7.5mg base) Body weight (kg) Single dose of primaquine (mg base) 10a to < 25 3.75 3.75 25 to < 50 7.5 7.5 50 to 100 15 15 a Dosing of young children weighing < 10 kg is limited by the tablet sizes currently available.