Primaquine and Related Topics

Malaria

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Mosquito-borne infectious disease that affects humans and other animals.

The life cycle of malaria parasites. Sporozoites are introduced by a mosquito bite. They migrate to the liver, where they multiply into thousands of merozoites. The merozoites infect red blood cells and replicate, infecting more and more red blood cells. Some parasites form gametocytes, which are taken up by a mosquito, continuing the life cycle.

Micrograph of a placenta from a stillbirth due to maternal malaria. H&E stain. Red blood cells are anuclear; blue/black staining in bright red structures (red blood cells) indicate foreign nuclei from the parasites.

Electron micrograph of a Plasmodium falciparum-infected red blood cell (center), illustrating adhesion protein "knobs"

The blood film is the gold standard for malaria diagnosis.

Ring-forms and gametocytes of Plasmodium falciparum in human blood

An Anopheles stephensi mosquito shortly after obtaining blood from a human (the droplet of blood is expelled as a surplus). This mosquito is a vector of malaria, and mosquito control is an effective way of reducing its incidence.

Man spraying kerosene oil in standing water, Panama Canal Zone, 1912

Walls where indoor residual spraying of DDT has been applied. The mosquitoes remain on the wall until they fall down dead on the floor.

An advertisement for quinine as a malaria treatment from 1927.

Deaths due to malaria per million persons in 2012

Past and current malaria prevalence in 2009

Ancient malaria oocysts preserved in Dominican amber

British doctor Ronald Ross received the Nobel Prize for Physiology or Medicine in 1902 for his work on malaria.

Chinese medical researcher Tu Youyou received the Nobel Prize for Physiology or Medicine in 2015 for her work on the antimalarial drug artemisinin.

Artemisia annua, source of the antimalarial drug artemisinin

U.S. Marines with malaria in a field hospital on Guadalcanal, October 1942

Members of the Malaria Commission of the League of Nations collecting larvae on the Danube delta, 1929

1962 Pakistani postage stamp promoting malaria eradication program

Disability-adjusted life year for malaria per 100,000 inhabitants in 2004
no data
<10
0–100
100–500
500–1000
1000–1500
1500–2000
2000–2500
2500–2750
2750–3000
3000–3250
3250–3500
≥3500

Treatment of P. vivax requires both treatment of blood stages (with chloroquine or artemisinin-based combination therapy) and clearance of liver forms with an 8-aminoquinoline agent such as primaquine or tafenoquine.

Plasmodium vivax

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Protozoal parasite and a human pathogen.

Where an artemisinin-based combination therapy has been adopted as the first-line treatment for P. falciparum malaria, it may also be used for P. vivax malaria in combination with primaquine for radical cure.

Glucose-6-phosphate dehydrogenase deficiency

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Most common enzyme deficiency worldwide, is an inborn error of metabolism that predisposes to red blood cell breakdown.

It is recommended that people be tested for G6PDD before certain medications, such as primaquine, are taken.

Clindamycin

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Antibiotic medication used for the treatment of a number of bacterial infections, including osteomyelitis or joint infections, pelvic inflammatory disease, strep throat, pneumonia, acute otitis media (middle ear infections), and endocarditis.

Clindamycin may also be used to treat toxoplasmosis, and, in combination with primaquine, is effective in treating mild to moderate Pneumocystis jirovecii pneumonia.

Plasmodium ovale

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Species of parasitic protozoa that causes tertian malaria in humans.

Standard treatment is concurrent treatment with chloroquine and primaquine.

8-Aminoquinoline

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8-amino derivative of quinoline.

The derivatives primaquine, tafenoquine and pamaquine have been tested for anti-malaria activity.

Pamaquine

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8-aminoquinoline drug formerly used for the treatment of malaria.

It is closely related to primaquine.

Tafenoquine

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Medication used to prevent and to treat malaria.

Tafenoquine is related to primaquine.

Pneumocystis jirovecii cysts from bronchoalveolar lavage, stained with Toluidine blue O stain

Pneumocystis pneumonia

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Form of pneumonia that is caused by the yeast-like fungus Pneumocystis jirovecii.

X-ray and CT of ground glass opacities and pneumothorax in pneumocystis pneumonia.

Chest X-ray of increased opacification (whiteness) in the lower lungs.

These chest radiographs are of two patients. Both show ground glass opacities. The left X-ray shows a much more subtle ground-glass appearance while the right X-ray shows a much more gross ground-glass appearance mimicking pulmonary edema.

X-ray of a cyst in pneumocystis pneumonia<ref name=Khan2010>{{cite journal|last1=Khan|first1=AliNawaz|last2=Allen|first2=CarolynM|last3=AL-Jahdali|first3=HamdanH|last4=Irion|first4=KlausL|last5=Al Ghanem|first5=Sarah|last6=Gouda|first6=Alaa|title=Imaging lung manifestations of HIV/AIDS|journal=Annals of Thoracic Medicine|volume=5|issue=4|year=2010|pages=201–16|issn=1817-1737|doi=10.4103/1817-1737.69106|pmid=20981180|pmc=2954374}} Creative Commons Attribution License</ref>

High-resolution computed tomography (HRCT) showing ground-glass attenuation with a geographic or mosaic distribution.

HRCT of cysts of pneumocystis pneumonia. These are usually multiple and bilateral, but range in size, shape and distribution.

Other medications that are used, alone or in combination, include pentamidine, trimetrexate, dapsone, atovaquone, primaquine, pafuramidine maleate (under investigation), and clindamycin.

WHO Model List of Essential Medicines

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The WHO Model List of Essential Medicines (aka Essential Medicines List or EML ), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health system.