What is the Radical Cure treatment?

The aim of the Radical Cure of Malaria treatment is to eliminate the latent forms (hypnozoites) of the parasites in case of P. vivax infections.

How is it working?

Above all, the participant must not meet the following criteria:

  • G6PD < 6
  • Hb < 9 g/dl
  • previously side effects with primaquine, choloriquine or tafenoquine
  • severe mental health problems
  • breast-feeding or wish to become pregnant within the next three months
  • current malaria (symptoms or positive RDT)
  • use of tafenoquine in the past 3 months or primaquine in the past month
  • refusing the follow-up treatment for 14 days following the first dose of treatment

Then, to determine if participants are eligible for the treatment, their exposure – and therefore the possibility of carrying latent forms of malaria – is assessed using a probabilistic method based on specific criteria. These criteria are determined by algorithms when the participation questionnaire is administered via the tablet.
At the end of the questionnaire, the tablet will indicate whether or not the participant can receive the Radical Cure treatment.

Administrated treatment

Two treatments are provided according to their availability: the primaquine and the tafenoquine.

  • Primaquine : 0.5 mg/kg/day during 7 days
    OR
  • Tafenoquine : 300 mg in a single dose

These treatments are combined with chloroquine (dose adapted according to the weight of the participant) for a better efficiency of the 8-amino-quinolines and eliminate any associated plasma forms.

 

A specific training is provided to the participants on the steps to follow to take their treatment and the standard procedure in case of adverse reactions.

Explanatory flyers, suitable for everyone to understand, are given with the treatment summirizing information for those included.

Surveillance of adverse events

A specific surveillance of adverse effects is systematically set up for the 14 days following the first day of Radical Cure treatment. For that, contact is made at D2, D5 and D14 either by phone, face-to-face with a facilitator (if the participant stays at the logistic base) or via the application installed on the participant’s phone. At any time, participants can be in contact with a doctor who, after assessing the situation, will advise him on first measure to be done and organise a medical appointment if necessary.

Potential adverse events expected with chloroquine / primaquine / tafenoquine are:

  • Yellowish discolouration of the eyes or skin
  • Red, itchy skin
  • Shortness of breath, breathing difficulties
  • Abnormal tiredness
  • Palpitations or change in heart rhythm
  • Black or dark urine