A open label, randomized controlled trial of Artesunate Sulfadoxine- Pyrimethamine (AS-SP) vs Artesunate – Sulfadoxine-Pyrimethamine + Primaquine (AS-SP+PQ) for decreasing malaria transmission in India

Objectives

Artemisinin combination therapies (ACTs) are now the first-line malaria treatment in most countries including India. A key benefit of ACTs is their activity against immature gametocytes and subsequent reduction of transmission. It is unclear though whether the addition of another agent to eliminate mature gametocytes will be advantageous. Before the switch to ACT, the use of primaquine for gametocidal effect was part of the national drug policy in India. A single dose of primaquine is inexpensive and effective against all stages of gametocytes. Thus, the key operational question now is whether primaquine should be added to artemisinin combination treatments for the treatment of falciparum malaria to reduce further the transmissibility of the treated infection. Currently, we have little data regarding the safety and efficacy of doing so.