ASSESSING THE CLINICAL AND ETHICAL SIGNIFICANCE OF G6PD STATUS PRIOR TO PRIMAQUINE PRESCRIPTION FOR MALARIAL MANAGEMENT IN THE COMMUNITY HEALTH

Primaquine is the widely used and presently the sole medication available for the obliteration of the recurrences of malaria caused by P.vivax and P. ovale because it is highly effective against latent malarial hypnozoites. Primaquine belongs to the class of 8-aminoquinoline drugs which is believed to act either by disrupting the Electron Transport Chain in parasite’s mitochondria or via synthesizing the moieties of oxygen which are reactive and are involved in the destruction of parasites at cellular level. Primaquine is contraindicated in all those persons who are not tested for G6PD levels so while prescribing primaquine G6PD test is mandatory. The recommended regimen for safe usage of primaquine should eventually be adjusted according to the G6PD level of the patients. The objective of study is to evaluate the clinical as well as ethical significance of G6PD status prior to primaquine prescription for malarial management in the community health. The study was quantitative and cross sectional. The study primarily focused on whether International and National guidelines about Malarial Management are being followed in Hospitals during Malarial peak season. Two reliable and validated questionnaire were used for data collection. First questionnaire was designed for Health-care providers to track their responses about International and National Malarial Guidelines Management and the second questionnaire was particularly designed for patients to know their response whether they were properly guided about standard protocols followed worldwide. The assessment was made known to the participants, and they were asked to give their consent for participation. For the analysis of data SPSS; version.26 was used. We conducted our study on about 200 malarial patients who were prescribed Primaquine for radical cure to prevent relapse. A large chunk of patients were either in their early 20s or in the late 30s. Our study also  included responses from 50 healthcare providers. Our goal was to assess clinical significance from health-care providers response and ethical significance from patients response. G6PD Status prior to Primaquine prescription is considered standard of care to avoid the risk of Hemolytic Anemia but our study found that no such standards were being followed at all. Physicians were no longer going for G6PD screening for almost any patient. Training programs should be conducted and active participation of healthcare providers should be ensured about International and National Guidelines.