Journal article

Cost-Effectiveness Analysis of Sex-Stratified Plasmodium vivax Treatment Strategies Using Available G6PD Diagnostics to Accelerate Access to Radical Cure

Angela Devine, Rosalind E Howes, David J Price, Kerryn A Moore, Benedikt Ley, Julie A Simpson, Sabine Dittrich, Ric N Price

American Journal of Tropical Medicine and Hygiene | AMER SOC TROP MED & HYGIENE | Published : 2020

Abstract

Tafenoquine has been licensed for the single-dose radical cure of Plasmodium vivax in adults; however, it is only recommended in patients with > 70% of normal glucose-6-phosphate dehydrogenase (G6PD) activity. Because this may hinder widespread use, we investigated sex-based treatment strategies in which all adult patients are tested with a qualitative G6PD rapid diagnostic test (RDT). Glucose-6-phosphate dehydrogenase normal males are prescribed tafenoquine in all three strategies, whereas G6PD normal females are prescribed either a low-dose 14-day primaquine regimen (PQ14, total dose 3.5 mg/kg) or a high-dose 7-day primaquine regimen (PQ7, total dose 7 mg/kg), or referred to a healthcare f..

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Grants

Awarded by Australian Centre for Research Excellence on Malaria Elimination (ACREME) - National Health and Medical Research Council of Australia


Awarded by DFID/MRC/Wellcome Trust Joint Global Health Trials Scheme


Awarded by Bill & Melinda Gates Foundation


Funding Acknowledgements

This work was supported by the Australian government through the Foundation for Innovative New Diagnostics (FIND), and the Australian Centre for Research Excellence on Malaria Elimination (ACREME), funded by the National Health and Medical Research Council of Australia (APP 1134989). Additional funding for the primary data collection was provided by the DFID/MRC/Wellcome Trust Joint Global Health Trials Scheme (MR/K007424/1) and the Bill & Melinda Gates Foundation (OPP10544044). R. N. P. is a Wellcome Trust senior fellow in clinical science (200909).