A 28-year-old man with Plasmodium vivax malaria has completed three days of chloroquine. The physician intends to prescribe the 14-day radical cure course of primaquine. Which investigation should be done before starting primaquine?

• A Serum bilirubin
• B Urine routine examination
• C Repeat peripheral smear
• D G6PD enzyme assay ✓

Explanation

Primaquine causes haemolysis in persons deficient in glucose-6-phosphate dehydrogenase, so G6PD status must be checked before giving the 14-day radical cure course for vivax malaria. In G6PD-deficient patients the weekly regimen is used under supervision. A repeat smear confirms parasite clearance but does not predict haemolysis, and liver function tests are not routinely required before primaquine therapy.

Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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