D. Gray Heppner, MD; Robert A. Gasser, MD; Kent E. Kester, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Heppner DG, Gasser RA, Kester KE. Primaquine Prophylaxis against Malaria. Ann Intern Med. 1999;130:536. doi: 10.7326/0003-4819-130-6-199903160-00009
Download citation file:
Published: Ann Intern Med. 1999;130(6):536.
TO THE EDITOR:
Malaria prophylaxis for travelers should be safe and should protect against Plasmodium falciparum and P. vivax, the two most prevalent species. In this light, we discuss Soto and colleagues' report of primaquine prophylaxis against malaria (1).
First, the importance of excluding G6PD deficiency before primaquine prophylaxis cannot be overstated. G6PD deficiency, originally described as “primaquine sensitivity,” is characterized by hemolysis that is clinically apparent 6 to 72 hours after exposure to oxidant drugs such as primaquine. African-American persons are commonly G6PD deficient, as demonstrated by Hockwald and colleagues (2), who administered primaquine, 30 mg/d, for 14 days to 110 healthy African-American men. Because of G6PD deficiency, 5 of the 110 had decreases in their hemoglobin level of greater than 4 g/dL and thus had to discontinue primaquine prophylaxis, and 17 of the remaining 105 had mild, self-limited anemia (mean decrease in hemoglobin level, 1.8 g/dL). Inadvertent administration of primaquine, 30 mg/d, to G6PD-deficient Americans of Mediterranean, Middle Eastern, or South Asian ancestry, in whom G6PD deficiency is more severe but less prevalent, would be worse.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only