Treatment of P. vivax or P. ovale Malaria with Intermediate G6PD Activity (30–70% of Normal)

Clinical Scenario

This protocol addresses patients with confirmed Plasmodium vivax or Plasmodium ovale malaria in whom G6PD enzyme activity is measured at 30–70% of normal — an intermediate level that distinguishes them from both fully G6PD-normal individuals and those with severe deficiency.

Key Condition: Intermediate G6PD Deficiency

G6PD activity in the 30–70% range represents an intermediate category that carries specific implications for anti-relapse agent selection. Tafenoquine is contraindicated in this setting. An alternative anti-relapse agent is used instead, and its administration requires specific precautions appropriate to this enzyme activity range.

Treatment Approach

Because tafenoquine cannot be given, primaquine is selected as the anti-relapse agent — administered under precautions tailored to intermediate G6PD status. The full regimen details, including duration and monitoring requirements, are in the complete protocol.

Full regimen available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

If the patient has intermediate G6PD deficiency between 30 and 70% tafenoquine should not be given; primaquine should be used at a regimen of 0.5 mg/kg/day for 14 days or for 7 days, with precautions.

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