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1. P vivax from Papua New Guinea and Indonesia should be assumed to be chloroquine-resistant; otherwise all non-falciparum species are chloroquine-sensitive and should receive chloroquine.

2. Primaquine is adjunctive medication for infections with P vivax and P ovale to eradicate hypnozoites in the liver.

3. Hypnozoites are the malarial forms responsible for relapse.

4. Remember that primaquine induces hemolytic anemia in G6PD-deficient persons, so you must screen for G6PD deficiency before prescribing it.

5. Prophylaxis in chloroquine-sensitive areas: Use chloroquine.

6. Prophylaxis in chloroquine-resistant areas: Use mefloquine or atovaquone/proguanil.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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