Hypnozoites resistant to primaquine: the first case reported from Kuwait

ABSTRACT

Primaquine is the only drug currently in use to eliminate the gametocytes of Plasmodium Vivax [PV] and also, destroys hypnozoites [latent liver stages] of PV and Plasmodium ovale [PO] and thereby effects a radical cure. The usual dose for antirelapse therapy for PO infection is 15 mg base daily for 14 days or once weekly for 8 weeks. Radical cure of PV in some parts of South-East Asia and Oceania requires higher total doses of primaquine [15-22.5 mg base daily for 14 days or once weekly for 8 weeks]. In Kuwait, 30 mg of primaquine is given weekly for 8 weeks as a radical cure according to WHO recommendations. In this paper, we report a case of a patient in whom, hypnozoites were resistant to primaquine at 45 mg weekly, for 8 weeks