ArticlePLoS medicine2024
Tafenoquine following G6PD screening versus primaquine for the treatment of vivax malaria in Brazil: A cost-effectiveness analysis using a transmission model.
Article in PLoS medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Strategic resource allocation for malaria elimination in endemic settings: a systematic review of cost-effectiveness evidence.Frontiers in public health · 2025Pooled it
- CYP3A and CYP2D6 variability in antimalarial pharmacokinetics and pharmacogenetics across populations: a narrative review.Malaria journal · 2026Review
- Article
- [Expansion of the use of technologies to reduce cases of malaria due to Plasmodium vivax in the Brazilian Amazon: a budget impact analysis].Cadernos de saude publica · 2026Article
- Towards Malaria Elimination: A Nationwide Case-Control Study to Assess Risk Factors for Severe Malaria-Related Deaths in Brazil.Tropical medicine & international health : TM & IH · 2025Article
- The probability of Plasmodium vivax acute illness following primary infection and relapse in Papua New Guinea.PLoS neglected tropical diseases · 2025Article
- Quantifying Plasmodium vivax radical cure efficacy: a modelling study integrating clinical trial data and transmission dynamics.The Lancet. Infectious diseases · 2025Article
- Towards malaria elimination: a case-control study to assess associated factors to malaria relapses in the extra-Amazon Region of Brazil from 2008 to 2019.Malaria journal · 2024Article
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Authors and funding
8 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMalaria transmission modelling has demonstrated the potential impact of semiquantitative glucose-6-phosphate dehydrogenase (G6PD) testing and treatment with single-dose tafenoquine for Plasmodium vivax radical cure but has not investigated the associated costs. This study evaluated the cost-effectiveness of P. vivax treatment with tafenoquine after G6PD testing using a transmission model. METHODS AND
findingsWe explored the cost-effectiveness of using tafenoquine after G6PD screening as compared to usual practice (7-day low-dose primaquine (0.5 mg/kg/day) without G6PD screening) in Brazil using a 10-year time horizon with 5% discounting considering 4 scenarios: (1) tafenoquine for adults only assuming 66.7% primaquine treatment adherence; (2) tafenoquine for adults and children aged >2 years assuming 66.7% primaquine adherence; (3) tafenoquine for adults only assuming 90% primaquine adherence; and (4) tafenoquine for adults only assuming 30% primaquine adherence. The incremental cost-effectiveness ratios (ICERs) were estimated by dividing the incremental costs by the disability-adjusted life years (DALYs) averted. These were compared to a willingness to pay (WTP) threshold of US$7,800 for Brazil, and one-way and probabilistic sensitivity analyses were performed. All 4 scenarios were cost-effective in the base case analysis using this WTP threshold with ICERs ranging from US$154 to US$1,836. One-way sensitivity analyses showed that the results were most sensitive to severity and mortality due to vivax malaria, the lifetime and number of semiquantitative G6PD analysers needed, cost per malaria episode and per G6PD test strips, and life expectancy. All scenarios had a 100% likelihood of being cost-effective at the WTP threshold. The main limitations of this study are due to parameter uncertainty around our cost estimates for low transmission settings, the costs of G6PD screening, and the severity of vivax malaria.
conclusionsIn our modelling study that incorporated impact on transmission, tafenoquine prescribed after a semiquantitative G6PD testing was highly likely to be cost-effective in Brazil. These results demonstrate the potential health and economic importance of ensuring safe and effective radical cure.
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