National programmes: treatment of vivax malaria: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · National programmes: treatment of vivax malaria

Sample item

A non-pregnant 25-year-old man with normal G6PD status has a confirmed Plasmodium vivax infection. Which regimen is recommended under the national malaria programme?

AArtemether-lumefantrine for 3 days plus single-dose primaquine 0.75 mg/kgBChloroquine alone for 3 daysCQuinine for 7 days plus doxycyclineDChloroquine for 3 days plus primaquine 0.25 mg/kg daily for 14 days

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Chloroquine for 3 days plus primaquine 0.25 mg/kg daily for 14 days

Plasmodium vivax is treated with chloroquine over 3 days to clear blood stages and with primaquine at 0.25 mg/kg daily for 14 days to eradicate dormant liver hypnozoites and prevent relapse. Primaquine is withheld in pregnancy, in infants and in G6PD deficiency. Single-dose primaquine is the gametocidal add-on for falciparum malaria.

Option by option

A. Artemether-lumefantrine for 3 days plus single-dose primaquine 0.75 mg/kg
This combination is the uncomplicated falciparum regimen, not the vivax regimen.
B. Chloroquine alone for 3 days
Chloroquine alone leaves liver hypnozoites and permits relapse.
C. Quinine for 7 days plus doxycycline
Quinine and doxycycline is a second-line option for falciparum malaria, not first-line for vivax.
D. Chloroquine for 3 days plus primaquine 0.25 mg/kg daily for 14 days (correct)
Correct. Chloroquine clears the blood stages and 14-day primaquine achieves radical cure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is D, Chloroquine for 3 days plus primaquine 0.25 mg/kg daily for 14 days. Plasmodium vivax is treated with chloroquine over 3 days to clear blood stages and with primaquine at 0.

Why is "Artemether-lumefantrine for 3 days plus single-dose primaquine 0.75 m…" not the answer?

This combination is the uncomplicated falciparum regimen, not the vivax regimen.

Why is "Chloroquine alone for 3 days" not the answer?

Chloroquine alone leaves liver hypnozoites and permits relapse.

Why is "Quinine for 7 days plus doxycycline" not the answer?

Quinine and doxycycline is a second-line option for falciparum malaria, not first-line for vivax.

What concept does this question test?

It tests National programmes: treatment of vivax malaria in PSM. 25 mg/kg daily for 14 days to eradicate dormant liver hypnozoites and prevent relapse. Primaquine is withheld in pregnancy, in infants and in G6PD deficiency. Single-dose primaquine is the gametocidal add-on for falciparum malaria.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study National programmes: treatment of vivax malaria?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.