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Chloroquine has been the mainstay of treatment for Plasmodium vivax for over 60 years.1, 2 The first observations of chloroquine-resistant P vivax were published in 1989,3, 4 and over the subsequent two decades several reports suggested that chloroquine-resistant P vivax was present in most vivax-endemic countries.5 Suboptimal treatment results in recurrent parasitaemia, from both recrudescent infections and relapses arising from reactivation of the dormant liver stages. Recurrent parasitaemia is associated with a cumulative risk of severe anaemia, increased mortality, and greater transmission potential.6, 7, 8

Treatment options for chloroquine-resistant P vivax include optimising chloroquine regimens or changing policy to a more effective blood schizontocidal agent. In countries where high-grade chloroquine-resistant P vivax is prevalent, national treatment guidelines have been revised to a universal policy of…….. continue reading https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30348-7/fulltext?rss=yes&utm_campaign=update-laninf&utm_source=hs_email&utm_medium=email&utm_content=64669744&_hsenc=p2ANqtz-9WpYs73h1mfrSVckwsm39Z5eJTzlhxNVHLcOFLxTVJtxoC4bQQM9bI0aGIwpcqrjI6wvsM9kWTWAJN1KLnHUfznLsVTA&_hsmi=64669744