Radical cure

Radical cure refers to the complete elimination of all parasites from a patient's body, including both the blood and liver stages. This term is often used in the context of malaria, where it denotes the eradication of all forms of the parasite, including the dormant liver stages (hypnozoites) that can cause relapses.

Overview

The concept of radical cure is particularly relevant for Plasmodium vivax and Plasmodium ovale, two species of malaria parasites that can form dormant liver stages. These stages can reactivate weeks to months after the initial infection, causing a relapse of the disease. The radical cure of these species requires treatment with a drug that can kill the dormant liver stages, such as primaquine or tafenoquine.

Treatment

The World Health Organization recommends a 14-day course of primaquine for the radical cure of P. vivax and P. ovale malaria. However, this treatment can cause hemolysis in individuals with glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency), a genetic disorder that affects red blood cells. Therefore, G6PD testing is recommended before starting primaquine treatment.

Tafenoquine is a newer drug that can be taken as a single dose for the radical cure of P. vivax malaria. Like primaquine, it can cause hemolysis in individuals with G6PD deficiency.

Challenges

Several challenges exist in achieving a radical cure for malaria. These include the difficulty of diagnosing dormant liver stages, the risk of hemolysis with primaquine and tafenoquine treatment, and the need for adherence to a 14-day course of primaquine.

See also

• Malaria
• Plasmodium vivax
• Plasmodium ovale
• Primaquine
• Tafenoquine
• Glucose-6-phosphate dehydrogenase deficiency

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