To the Editor: The Australian Defence Force (ADF) has sustained many cases of malaria following service in East Timor.1 To reliably prevent relapse of malaria caused by the Chesson strain of Plasmodium vivax present in this region, larger doses of primaquine are required2 (up to 6 mg/kg total dose,3 compared with > 3.5 mg/kg to prevent relapse of sub-Saharan vivax malaria4). The ADF uses 1500 mg chloroquine (total base) followed by 315 mg primaquine (total base) for the treatment of vivax malaria, which, in Australia, is commonly treated either without primaquine or with inadequate dosages of either chloroquine or primaquine.5
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- 1. Kitchener SJ, Auliff AM, Rieckmann KH. Malaria in the Australian Defence Force during and after participation in the International Force in East Timor (INTERFET). Med J Aust 2000; 173: 583-585. <eMJA full text>
- 2. Ehrman FC, Ellis JM, Young MD. Plasmodium vivax Chesson Strain. Science 1945; 101: 377.
- 3. Clyde DF, McCarthy VC. Brief communications. Radical cure of Chesson strain vivax malaria in man by 7, not 14 days of treatment with primaquine. Am J Trop Med Hyg 1977; 26: 562-563.
- 4. Schwartz E, Regev-Yochay G, Kurnik D. Short report: a consideration of primaquine dose adjustment for radical cure of Plasmodium vivax malaria. Am J Trop Med Hyg 2000; 62: 393-395.
- 5. McCall BJ, Pearce MC. Malaria treatment in Queensland, 1992. The use of malaria treatment guidelines. Med J Aust 1994; 161: 259-262.