Primaquine for Plasmodium vivax Radical Cure: G6PD Testing Strategies and Relapse Prevention Efficacy

Niwarinda Arnold

Department of Pharmacy Kampala International University Uganda

Email: arnold.niwarinda@studwc.kiu.ac.ug
                                                                     ABSTRACT
Plasmodium vivax malaria remained a significant global health burden, affecting approximately 14.3 million individuals annually, with its unique dormant hypnozoite stage in the liver presenting substantial challenges for complete parasite eradication. The persistent reactivation of these hypnozoites led to recurrent infections that compromised patient outcomes and sustained transmission cycles in endemic regions. Primaquine represented the only widely available medication capable of targeting hypnozoites for radical cure, yet its use was complicated by the risk of potentially life-threatening hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, an inherited enzymopathy affecting over 400 million people worldwide. This comprehensive review examined the biochemical mechanisms underlying primaquine efficacy and G6PD-related toxicity, evaluated current diagnostic strategies for G6PD screening, and analyzed the clinical evidence supporting various treatment regimens for relapse prevention. A systematic synthesis of peer-reviewed literature published between 2010 and 2025 was conducted to assess diagnostic accuracy, safety profiles, and therapeutic outcomes. Recent advances in point-of-care testing technologies and standardized dosing protocols have substantially improved the risk-benefit balance of primaquine administration. Implementation of appropriate G6PD screening before treatment can enable safe radical cure while minimizing hemolytic complications, though access to reliable diagnostics remains limited in resource-constrained settings where P. vivax is most prevalent.

Keywords: Primaquine; Plasmodium vivax; Glucose-6-phosphate dehydrogenase deficiency; Hypnozoite; Radical cure.

CITE AS: Niwarinda Arnold (2026). Primaquine for Plasmodium vivax Radical Cure: G6PD Testing Strategies and Relapse Prevention Efficacy. NEWPORT INTERNATIONAL JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES, 7(2):107-115.
https://doi.org/10.59298/NIJSES/2026/72.107115