Bibliographic information

GuidelineWHO guidelines for malaria, 25 November 2022.
Year of Publication2022
Issuing InstitutionWorld Health Organization

Recommendation

Maintained

In women who are pregnant or breastfeeding, consider weekly chemoprophylaxis with chloroquine until delivery and breastfeeding are completed, then, on the basis of glucose-6-phosphate dehydrogenase (G6PD) status, treat with primaquine to prevent future relapse.

Recommended in favor

Conditional

Notes and Remarks

Practical Info Primaquine is contraindicated in pregnant women and in lactating women (unless the infant is known not to be G6PD deficient). As an alternative, chloroquine prophylaxis could be given to suppress relapses after acute vivax malaria during pregnancy. Once the infant has been delivered and the mother has completed breastfeeding, primaquine could then be given to achieve radical cure. Few data are available on the safety of primaquine in infancy, and in the past primaquine was not recommended for infants. There is, however, no specific reason why primaquine should not be given to children aged 6 months to 1 year (provided they do not have G6PD deficiency), as this age group may suffer multiple relapses from vivax malaria. The guideline development group therefore recommended lowering the age restriction to 6 months.

Also Featured In

This recommendation also appears in the following guidelines:

Originally Developed
Guideline

Guidelines for the treatment of malaria

Year2015
InstitutionWorld Health Organization
Guideline

WHO guidelines for malaria, 16 February 2021.

Year2021
InstitutionWHO
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WHO guidelines for malaria, 13 July 2021.

Year2021
InstitutionWHO
Guideline

WHO guidelines for malaria, 18 February 2022.

Year2022
InstitutionWHO
Guideline

WHO guidelines for malaria, 31 March 2022.

Year2022
InstitutionWHO
Guideline

WHO guidelines for malaria, 3 June 2022.

Year2022
InstitutionWHO
Guideline

WHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025

Year2023
InstitutionWorld Health Organization
Guideline

WHO guidelines for malaria, 16 October 2023.

Year2023
InstitutionWorld Health Organization
Guideline

WHO Guidelines for malaria, 14 March 2023

Year2023
InstitutionWHO
Guideline

WHO guidelines for malaria, 30 November 2024.

Year2024
InstitutionWHO
Guideline

WHO guidelines for malaria, 13 August 2025

Year2025
InstitutionWorld Health Organization