Last Updated: 31/10/2025
Reducing the risk of P. Vivax after falciparum infections in co-endemic areas (PRIMA)
Objectives
Primary
- To assess the safety and efficacy of a 7-day course of high dose primaquine treatment regimen in preventing recurrent symptomatic P. vivax parasitaemia in G6PD normal patients following uncomplicated P. falciparum malaria.
Secondary
- To assess the efficacy of a 7-day course of high dose primaquine treatment regimen in preventing recurrent symptomatic and asymptomatic P. vivax and P. falciparum parasitaemia
- To assess the relationship between Hb and G6PD activity over time
In the Asia Pacific, National Malaria Control Programs repeatedly call for better approaches for radical cure, to meet their malaria elimination targets.
In the Asia Pacific region, the Horn of Africa and Americas, malaria is mostly caused by two species Plasmodium falciparum and P. vivax. Unlike P. falciparum, P. vivax forms dormant liver stages that reactivate weeks or months following an acute infection causing active disease. The WHO currently recommends a treatment with primaquine to kill the liver stage parasites, referred to as radical cure. But this is only indicated in patients presenting with P. vivax malaria. However recent evidence suggests that the risk of relapsing P. vivax malaria is higher after an acute P. falciparum infection than the natural relapse rate or the rate of reinfection would suggest. This suggests that in some locations a universal policy of primaquine radical cure for both falciparum and vivax malaria maybe warranted
To explore this strategy, we are conducting a randomised controlled trial to assess the safety and efficacy of primaquine treatment in patients with P. falciparum to reduce the risk of subsequent P. vivax episodes.
ClinicalTrials.gov ID: NCT03916003
- Allocation: Randomized
- Intervention Model: Parallel Assignment
- Masking: None (Open Label)
- Primary Purpose: Treatment
Aug 2019 — May 2022
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