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PSM · Communicable diseases: primaquine in falciparum malaria
Sample itemIn an endemic district a patient with uncomplicated Plasmodium falciparum malaria is treated with artemisinin combination therapy. A single low dose of primaquine is also added on the second day. What is its purpose?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. To kill gametocytes and reduce transmission
P. falciparum does not form hypnozoites, so primaquine is not given for radical cure. A single low dose acts on mature gametocytes, which artemisinins do not reliably kill, and reduces onward transmission to mosquitoes. G6PD status and pregnancy are considered before use.
Option by option
A. To kill the asexual blood stages
The asexual blood stages are killed by artemisinin combination therapy.
B. To eradicate hypnozoites and prevent relapse
Hypnozoites occur in P. vivax and P. ovale, not in P. falciparum.
C. To treat severe malaria with cerebral involvement
Severe malaria needs parenteral artesunate, and a single low dose of primaquine has no role in treating it.
D. To kill gametocytes and reduce transmission (correct)
Correct. A single low dose of primaquine is gametocidal and reduces transmission.
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.
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