Safety of weekly primaquine in G6PD deficient patient with relapsing vivax malaria: A case report

of all the malaria cases reported annually in India1. It has unique feature of causing relapses due to persistent liver stages of the parasite (hypnozoites), which makes control of vivax malaria challenging. Relapse rates of up to 40% have been reported from different parts of India2-3. In vivax malaria, relapses are known to dominate over the primary attacks4 and if 65% of vivax malaria cases are treated with antirelapse therapy, elimination would be possible in a decade5. Currently, primaquine is the only registered and marketed antirelapse agent; however, it is known to cause haemolysis in G6PD deficient individuals6-7. For targeted malaria elimination, it is important to administer primaquine in safe and effective doses in all the vivax malaria cases to prevent relapses. We present a case of vivax malaria with G6PD deficiency, in which primaquine was administered weekly in WHO recommended dosage. Weekly primaquine was found to be safe in G6PD deficient patient, and there were no clinical or laboratory manifestations of haemolysis.