Blocking malaria transmission with primaquine
When administered in a single low dose, with standard antimalarial treatment, called artemisinin-based combinations, primaquine blocks the transmission of malaria between humans and mosquitoes. This is referred to its gametocytocidal activity i.e., killing the sexual forms of the malaria parasites. These male and female forms are taken up by mosquitoes where they mate to produce the forms that then infect humans. If deployed on a wide scale, single low-dose primaquine should benefit communities and play an instrumental role in eliminating malaria.
Strategy
The IMPRIMA project is based on the implementation of several complementary actions (clinical, community/sociological and political) and capacity building in three endemic African countries with different epidemiological contexts (Burkina Faso, Madagascar and Burundi). It aims to generate data demonstrating the safety, acceptability and impact at the community level of taking SLDPQ.
WHO recommendations
For more than a decade now, the WHO has recommended a single low-dose of primaquine be added to the standard treatment of acute, uncomplicated Plasmodium falciparum in areas with low malaria transmission. So far, however, this recommendation has not been implemented consistently across sub-Saharan Africa.
Map of implementing countries
The IMPRIMA project is based on the implementation of several complementary work packages (clinical, community/sociological and political), and capacity building, in three endemic African countries with different malaria epidemiologies, namely, Burkina Faso, Madagascar and Burundi. It aims to generate data demonstrating the safety, acceptability and impact at community level of taking SLDPQ.
IMPRIMA follows on from the “Developing Paediatric Primaquine” project, funded by the EDCTP2 programme (www.dpp-project.org), that aims to develop and clinically validate paediatric forms of primaquine.
The strong commitment of the IMPRIMA consortium players is key to its success and a fundamental step towards eliminating malaria in Africa. At the same time, an important underlying theme is strengthening the technical capabilities of the teams in the field to, particularly, monitor the development of malaria resistance to artemisinin and the partner drugs.
The complementary nature of the partners in the IMPRIMA consortium, the integration of the clinical, sociological, political and educational aspects, plus the diversity of the different epidemiological contexts are valuable elements that should see the successful implementation of the project and its reception by control programmes and the wider malaria community.
The clinical study will generate substantial, real-life evidence on the safety and acceptability of SLDPQ in large number of patients and assess, over two years, whether transmission is reduced and the effect on drugs resistance. The social and political studies, which will also include training activities, will complement the clinical evidence.
All in all, IMPRIMA aims to instill confidence in the strategy of deploying SLDPQ and its acceptance by communities and policy makers at country and international level.
Timeframe
4-year project from April 2023 to 2027
- One year of preparation
- Two years for field operations
- Final year to take stock and prepare the toolboxes.
DDP & IMPRIMA projects
Complementarity and safety
The flavoured primaquine tablets used in the IMPRIMA project are pharmaceutically certified. The batches intended for the DPP and IMPRIMA clinical trials have been issued with certificates of analysis and they meet international standards of quality (Appendices : investigation document and certificate of analysis). All the technical information required for import permit applications in the three countries has been collected.
