Funders:
  • National Health and Medical Research Council 
Collaborators:
  • Icddr,b (Bangladesh)
  • Agha Khan University (Pakistan)
Project team:

Chief Investigator: 

Menzies Investigators:

Other key investigators:

  • Prof. Najia Ghanci (Agha Khan University, Pakistan)
  • Prof. Asim Beg (Agha Khan University, Pakistan)  
  • Dr Shafiul Alam (icddr,b; Bangladesh)
  • Dr Megha Rajasekhar (University of Melbourne)
  • Dr. Ari Winasti Satyagraha (National Research and Innovation Agency, Republic of Indonesia) 
  1. MEDIA RELEASE | Is malaria treatment safer than we think? New study investigates

    MEDIA RELEASE | Is malaria treatment safer than we think? New study investigates

    Date

    A new international research collaboration led by Menzies is set to examine whether the risk of severe side effects from vivax malaria medication, primaquine, is lower than assumed to date.

Aims: 
  1. To quantify the change in glucouse-6-phospate dehydrogenase (G6PD) activity over time in individuals with and without (controls) P. vivax malaria.
  2. To determine whether G6PD activity at enrolment or during steady state is associated with primaquine-induced haemolysis.
  3. To characterise determinants of the observed change in G6PD activity.
Summary:

8-aminoquinolines are essential for the treatment of vivax malaria but can cause severe side effects in individuals with low G6PD enzyme activity. Our preliminary data suggest that the activity of the G6PD enzyme increases in the course of a vivax malaria infection. This phenomenon has not been described before. This study therefore assesses the impact a symptomatic vivax malaria infection has on G6PD enzyme activity. 

We will enrol 160 vivax malaria patients and 160 sex, age and site matched malaria free individuals at sites in Pakistan and Bangladesh. G6PD enzyme activity will be measured repeatedly five times over six months in all participants. We will then assess whether G6PD activity is increased during the malaria episode and how long it takes for G6PD enzyme activity levels to return to normal.

Implications for policy and practice:

If we can confirm our hypothesis more than 50% of patients currently considered ineligible for standard vivax malaria treatment could be eligible, rendering treatment much safer than has been assumed to date.

Chief Investigator:
Project Manager: 
Contact: 
Project dates:

1 March 2024 - 31 December 2026

Articles that justify this research:

  • Ley B, Alam MS, Satyagraha AW, Phru CS, Thriemer K, Tadesse D, Shibiru T, Hailu A, Kibria MG, Hossain MS, Rahmat H, Poespoprodjo JR, Khan WA, Simpson JA, Price RN. Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria. PLoS Negl Trop Dis. 2022 May 11;16(5):e0010406. doi: 10.1371/journal.pntd.0010406. PMID: 35544453; PMCID: PMC9094517.
  • Ley B, Alam MS, Kibria MG, Marfurt J, Phru CS, Ami JQ, Thriemer K, Auburn S, Jahan N, Johora FT, Hossain MS, Koepfli C, Khan WA, Price RN. Glucose-6-phosphate dehydrogenase activity in individuals with and without malaria: Analysis of clinical trial, cross-sectional and case-control data from Bangladesh. PLoS Med. 2021 Apr 23;18(4):e1003576. doi: 10.1371/journal.pmed.1003576. PMID: 33891581; PMCID: PMC8064587.