No | Author | Country | Number of Subjectsa | Age range | Type of Malaria | Method | Studied drugs, doses (duration) | Duration of Follow Up | Mean difference (SD or 95% CI), G6PD def. vs. normal | Risk ratio anaemia (95% CI) | Other related outcomes |
---|---|---|---|---|---|---|---|---|---|---|---|
Single dose 0.25 mg/kg PQ | |||||||||||
1 | Mwaiswelo et al. [24] | Tanzania | 88 G6PDn, 21 G6PDd | ≥ 1 y.o | P.f | RCT | PQ 0.25 mg/kg (SD) | 7 days | 1.16 (0.67–1.66) vs. 0.81 (0.59–1.02) | N/A | Mean relative Hb reduction (%) (95% CI) G6PD def. vs. normal: 7.9 (4.58–11.18) vs. 7.2 (5.04–9.35) |
2 | Bastiaens et al. [19] | Burkina Faso, Gambia | 20 G6PDn, 42 G6PDd | 10–45 y.o | P.f | RCT | 1. PQ 0.25 mg/kg (SD) | 7, 28 days | Burkina Faso Day 7, dose 0.25 mg/kg: − 0.92 (1.43) vs − 0.64 (1.01) Day 28, dose 0.25 mg/kg: − 0.29 (1.83) vs 0.04 (1.27) Gambia Day 7, dose 0.25 mg/kg: − 0.99 (0.85) vs − 1.06 (1.55) Day 28, dose 0.25 mg/kg: − 0.52 (1.18) vs − 0.4 (2.01) | Changes in Hb conc. > − 2.5 g/dL: Burkina Faso Dose PQ 0.25 mg/kg RR = 1.13 [0.46, 2.77] Gambia Dose PQ 0.25 mg/kg RR = 0.60 [0.17, 2.14] | N/A |
3 | Dysoley et al. [21] | Cambodia | 47 G6PDn, 9 G6PDd | 4–76 y.o | P.f | RCT | PQ 0.25 mg/kg (SD) | 7 days | − 1.46 (− 3.3–0.4) g/dL vs. − 1.24 (− 4.6–2.4) g/dL | Hb reduction ≥ 25% normal, RR: 1.04 [0.14, 7.91] | Mean Hb, G6PD def. vs. normal: 10.9 (8.5–13.2) vs. 12.05 (8.7–14.5) |
4 | Raman et al. [23] | South Africa | 55 G6PDn, 11 G6PDd | ≥ 2 y.o | P.f | RCT | PQ 0.25 mg/kg (SD) | 7, 14, 28, 42 days | N/A | N/A | 11 subjects with G6PD deficiency reached the lowest median Hb during day 7, compared to G6PD normal group |
Single dose 15 mg | |||||||||||
1 | Tine et al. [22] | Senegal | 105 G6PDn, 30 G6PDd | 18–74 y.o | P.f | RCT | PQ 15 mg (SD) | 7, 28 days | Day 7, G6PD def. vs normal: − 1.75 (− 6.1, 2.6) vs − 1.36 (− 4.7, 3.3) Day 28, G6PD def. vs normal: − 0.24 (− 3.3, + 3) vs – 0.32 (− 3.7, + 4.8) | Hb reduction > 2 g/dL in day 7, RR = 1.12 [0.78, 1.62] | Mean Hb, Day 28, G6PD def. vs. normal: 12,8 (0.87) vs. 13,2 (1.26) |
Single dose 0.25–0.5 mg/kg | |||||||||||
1 | Bastiaens GJH et al. [19] | Burkina Faso, Gambia | 11 G6PDn, 24 G6PDd | 10–45 y.o | P.f | RCT | PQ 0.4 mg/kg (SD) | 7, 28 days | Burkina Faso Day 7, dose 0.4 mg/kg: − 0.93 (1.20) vs − 0.60 (1.70) Day 28, dose 0.4 mg/kg: − 0.10 (1.13) vs − 0.12 (2.01) | Changes in Hb conc. > − 2.5 g/dL: Dose PQ 0.4 mg/kg RR = 0.70 [0.30, 1.66] | N/A |
Single dose 0.75 mg/kg | |||||||||||
1 | Ley et al. [29] | Bangladesh | 91 G6PDn, 4 G6PDd | > 1 y.o | P.f | Cohort | PQ 0.75 mg/kg, SD (P.f) | 30 days | N/A | N/A | Mean fractional Hb reduction in day 7, G6PD def. vs normal: − 9.1% (− 53.2%, + 35.0%) vs. + 2.9% (− 1.14%, + 6.8%), p = 0.739 |
PQ daily ≤ 0.25 mg/kgb | |||||||||||
1 | Poirot et al. [25] | Senegal, Bangladesh, Tanzania, Swaziland | 107 G6PDn, 16 G6PDd | > 1 y.o | P.f, P.v, mix | RCT & cohort | PQ ≤ 0.25 mg/kg | 7 days | PQ ≤ 0.25 mg/kg: − 1.38 [− 2.13, − 0.63] vs. − 1.27 [− 1.56, − 0.99] | N/A | N/A |
2 | Avalos S et al. [28] | Honduras | 48 G6PDn, 7 G6PDd | > 10 y.o | P.f, P.v | Cohort | PQ 0.25 mg/kg, 14d in P. vivax PQ 0.75/kg, SD in P. falciparum | 7 days | All doses: − 1.63 (1.79) vs. − 0.28 (1.18), p = 0.040 | N/A | Mean Hb, G6PD def. vs. G6PD normal: 9.88 (1.63) vs. 12.07 (1.4), p = 0.040 |
3 | Leslie et al. [14] | Pakistan | 121 G6PDn, 1 G6PDd | N/A | P.v | RCT | 1. PQ 0.25 mg/kg (14 days) 2. PQ 0.75 mg/kg/week (8 weeks) | 14 days | N/A | N/A | On day 7, mean Hb fell below mean Hb in G6PD normal: 10.0 g/dL vs 12.6 g/dL), and rise back to normal in day 14: 12.7 g/dL vs. 12.6 g/dL) |
PQ daily > 0.25–0.5 mg/kgb | |||||||||||
1 | Brito− Sousa JD et al. [17] | Brazil | 672 G6PDn, 94 G6PDd | 4–84 y.o | P.v | Cohort | PQ 0.5 mg/kg, 7 days | 7 days | N/A | N/A | Rate of severe anemia in G6PD def. was 55/94 or 58.5% (no comparison to G6PD normal group) |
2 | Silva et al. [16] | Brazil | 8 G6PDn, 3 G6PDd | 18–60 y.o | P.v | Cohort | PQ 0.5 mg/kg (7 days) | 3 days | N/A | N/A | Mean Hb, G6PD def. vs. normal: 7.8 ± 0.3 vs. 12.73 ± 1.38 |
3 | A. Llanos-Cuentas et al. [15] | Peru, Brazil, Colombia, Vietnam, Thailand | 85 G6PDn & G6PDd, 6 G6PDd in all group studies | > 16 y.o | P.v | RCT | PQ 15 mg (14 days)) | 14 days | N/A | N/A | Among 5 subjects with protocol-defined Hb decreases, none are G6PD def. patient |
4 | Khoo KK et al. [26] | Malaysia | 23 G6PDd | > 1 y.o | P.f, P.v, mix | non-RCT | CQ + PQ – PQ 75 mg (3 days) (P.f) – PQ 210 mg (14 days) (P.v, mix) | 3, 14 days | N/A | N/A | Hemolysis in CQ + PQ group: 7/23 (30.4%) |
5 | Poirot et al. [25] | Senegal, Bangladesh, Tanzania, Swaziland | 125 G6PDn, 15 G6PDd | > 1 y.o | P.f, P.v, mix | RCT & cohort | 1. PQ 0.25–0.5/kg | 7 days | PQ > 0.25—≤ 0.5 mg/kg: − 1.19 [− 1.97, − 0.42] vs. − 0.63 [− 0.90, − 0.37] | N/A | N/A |
PQ daily > 0.5 mg/kg | |||||||||||
1 | Poirot et al. [25] | Senegal, Bangladesh, Tanzania, Swaziland | 152 G6PDn, 4 G6PDd | > 1 y.o | P.f, P.v, mix | RCT & cohort | 2. PQ > 0.5 mg/kg (SD or 14 days) | 7 days | PQ > 0.5 mg/kg: − 2.75 [− 4.22, − 1.28] vs. − 0.86 [− 1.1, − 0.62] | N/A | N/A |
PQ 0.75 mg/kg weekly | |||||||||||
1 | Kheng et al. [27] | Cambodia | 57 G6PDn, 18 G6PDd | > 1 y.o | P.v, mix | non-RCT | PQ 0.75 mg/kg/week (8 weeks) | 7, 28 days | D7: − 2.2 (− 4.9, 0.8) vs. − 0.5 (− 2.2, 2.8) D28: 0.3 (− 2.3, 2.7) vs. 0.2 (− 2, 2.6) | Hb reduction > 25% on day 7, RR: 33.58 [1.95, 579.53] | Mean Hb, G6PD def. vs. normal: D7: 10.9 (8.9, 13) vs. 13 (9.5, 15.7) D28: 13.5 (9.5–16.1) vs. 12.8 (10.9–15.4) |
CPG-DDS | |||||||||||
1 | Leslie et al. [18] | Afghanistan, Pakistan | 300 G6PDn,2 G6PDd | > 3 y.o | P.v | RCT | CPG-DDS (3 days) | 14 | N/A | N/A | 1 subject with G6PDd had Hb decreased 1.4 g/dL over 24 h |
2 | Tiono et al. [20] | Burkina Faso, Ghana, Mali, Nigeria | 824 G6PDn, 68 G6PDd | > 1 y.o | P.f | RCT | 1. CDA 2. CPG-DDS | 28 days | N/A | Hb reduction ≥ 4 g/dL or ≥ 40% baseline of Hb 5 g/dL or blood transfusion: – CDA, RR = 33.09 [11.27, 97.15] – CPG-DDS, RR = 10.74 [3.93, 29.37] | N/A |
Tafenoquine | |||||||||||
1 | A. Llanos- Cuentas et al.)[15] | Peru, Brazil, Colombia, Vietnam, Thailand | 166 G6PDn & G6PDd, 6 G6PDd in all group studies | > 16 y.o | P.v | RCT | Tafenoquine 300 mg (SD) | 14 days | N/A | N/A | Among 5 subjects with protocol-defined Hb decreases, none are G6PD def. patient |