Shortening the Journey to Cure: A Quasi-experimental Trial Comparing Seven-Day and 14-Day Primaquine Radical Therapy for Vivax Malaria

Introduction Because dormant liver-stage hypnozoites can cause recurrence, Plasmodium vivax (P. vivax) malaria poses serious problems. Although the standard treatment for radical cure is 14 days of primaquine medication, this lengthy course of treatment frequently causes poor adherence. In contrast to the typical 14-day low-dose regimen, this study assesses the effectiveness, safety, and adherence of a condensed seven-day high-dose primaquine regimen. Objectives The objectives of this study are to assess and compare the efficacy of seven-day high-dose primaquine therapy with 14-day low-dose therapy. Methodology Over nine months, this quasi-experimental study was carried out at the Hayatabad Medical Complex's General Medicine Unit in Peshawar, Pakistan. One hundred patients with confirmed P. vivax malaria, ages 18 to 76, were split into two groups. Group A (intervention group; n=50) was given primaquine (1 mg/kg/day) for seven days, whereas Group B (control group; n=50) was given primaquine (0.5 mg/kg/day) for 14 days. Assessments were conducted again on days 14, 28, 60, and 90 to look for relapse of febrile illness and/or parasitemia. IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States) was used to analyse treatment outcomes, such as adverse events, adherence, and illness recurrence. Results The disease recurrence rate was substantially lower in Group A (2%), which was receiving a shorter course of therapy, as compared to Group B (26%), which was given 14-day therapy. Chi-square analyses show significance with a p-value of 0.012. Additionally, the shorter regimen had a higher adherence rate (94%) compared to the 14-day regimen (76%) (p = 0.012). Both regimens were well tolerated, with a slightly increased occurrence of very mild gastrointestinal symptoms in Group A. No serious side effects were noted. Conclusion Similar efficacy to the conventional 14-day therapy is provided by the seven-day high-dose primaquine regimen, which also has an acceptable safety profile and much-improved adherence. In areas with limited resources where adherence to prolonged therapy is difficult, this condensed regimen may improve treatment outcomes.