Primaquine and relapses of Plasmodium vivax. Meta analysis of controlled clinical trials.

BACKGROUND Primaquine (PQ) is used against relapses of vivax malaria (RVM) but several aspects about dosage are unknown, as the total effective dose (TD) in a number of days. OBJECTIVE To compare PQ regimens against RVM in randomized or non randomized controlled clinical trials (CCTs). METHODOLOGY Meta analysis. Information was sought until 31 December, 2012 in Lilacs, SciELO, PubMed (Medline), Cochrane Library, Cochrane Infectious Diseases Group, Embase. Experimental studies or CCT were used, always with concurrent control group. No matter whether or not the design was randomized, close label, supervised. It is not required that the study established difference between relapse and reinfection by molecular evidence. Inclusion and exclusion criteria for articles were applied and meet the inclusion criteria constituted adequate quality to be left in the meta analysis. RESULTS 23 ECC with or without random allocation of treatment met the selection criteria. Include four schemes of TD (TD mg number of days): 210 14 = 210 mg in 14 days; 210 7 = 210 mg in 7 days, 45 to 150 mg in 3 to 10 days, 0 (not PQ). If PQ is absent, recurrences occurr 34.48% versus 19.66% with PQ 210 14 (significant difference), 210 14 showed effectiveness equal to that of 210 7. Treatments 210 7 and 210 14 were statistically better than 45 to 150 effectiveness. CONCLUSIONS The use of PQ is necessary to reduce recurrences and TD 210 mg given at 7 or 14 days is which is more effective but more studies are required to treatment 210 7.