Relapse rate of vivax malaria with shorter duration of antirelapse treatment in Iran

Every year thousand of malaria cases mostly the vivax type Occur in Iran. The
recommendation of WHO for antirelapes therapy of vivax malaria is the usage of primaquine
(15mg daily) for 14 days but in area where G6PD deficiency rate is high 8 weeks therapy
(each week 45 mg of primaquine) is recommended. Considering the fact that in Iran drug
therapy of malaria is implemented by direct observation of health care workers, 8 weeks
regime of antirelapes therapy of vivax is very expensive and in some situations impractical. In
this study shorter duration of antirelapse therapy was compared to that of 8 weeks regimen.
In 1996 and 1997 antirelapse therapy of vivax in Sistan and Baluchistan province in
southeast of Iran was done with different regimes according to manpower and executive
facilities. This is a cohort study that compare clinically and parasitologicaly relapse of vivax
malaria in 200 patients with one-week therapy, 200 patients with 2 weeks, 800 patients with 4
weeks and 500 patients with 8 weeks therapy by primaquine.
Relapes rate of vivax malaria by each regiem were 23.8%,13.2%,5.4% and 4.6% respectively
.Relative risk of relapse in comparison with 8 weeks regiem were 5.2 ,2.9 and 1.2 respectively
.Number need to therapy (NNT) were 5,12 and 125 .Interval of first relapse varied between 6
to 52 weeks with mean of 28.8 weeks . The relapse rate was not different by sex.
The relapse rate by 4 and 8 weeks regimes were low and there was not significant difference
of relapse rate in 4 and 8 weeks regimes. So in special situations we can use 4 weeks therapy
instead of 8 weeks therapy.