Safety and efficacy of primaquine in patients with Plasmodium vivax malaria from South Asia: a systematic review and individual patient data meta-analysis
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  • Published on:
    Robust medical research demands both reproducibility and generalizability to ensure that findings translate into effective clinical practice
    • Mohsen Salimi, General Practitioner Student Research Committee, Shiraz University of Medical Science, Shiraz, Iran

    This systematic review and individual patient data meta-analysis aimed to evaluate the safety and efficacy of primaquine in patients with Plasmodium vivax malaria from South Asia. The study's strengths include its comprehensive search strategy, thorough data extraction, and robust statistical analysis. However, several limitations and concerns arise from the study's methodology and results.

    Firstly, the study's generalizability is limited by its focus on South Asia, which may not be representative of other regions where P. vivax malaria is endemic. Additionally, the study only included patients with uncomplicated P. vivax malaria, which may not reflect the more severe cases often seen in clinical practice.

    Secondly, the study's inclusion criteria were quite restrictive, leading to the exclusion of 14 out of 32 identified studies due to lack of primaquine arm or incomplete data. This raises concerns about selection bias and the potential for missing important data.

    Thirdly, the study's definition of "low" and "high" total dose primaquine regimens seems arbitrary and may not be universally accepted. The categorization of daily doses into "low", "intermediate", and "high" also lacks clear justification.

    Fourthly, the study's haematological safety analysis was restricted to patients with ≥30% G6PD activity, which may not reflect the real-world scenario where patients wit...

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    Conflict of Interest:
    None declared.