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QUANTIFYING PRIMAQUINE EFECTIVENESS AND IMPROVING ADHERENCE: A ROUND TABLE DISCUSSION OF THE APMEN VIVAX WORKING GROUP
Plasmodium vivax
Adherence
Efectiveness
Efficacy
Radical cure
Primaquine
APMEN
Author
Affilliation
Abstract
The goal to eliminate malaria from the Asia-Pacifc by 2030 will require the safe and widespread delivery of efective radical cure of malaria. In October 2017, the Asia Pacifc Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difculties in assessing clinical efectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specifc strategies to improve adherence are needed to increase understanding and awareness of PQ within afected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their efectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its efectiveness.
Keywords
Vivax malariaPlasmodium vivax
Adherence
Efectiveness
Efficacy
Radical cure
Primaquine
APMEN
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