A 28-year-old man from Bihar presents with fever and rigors. Peripheral smear shows Plasmodium vivax. He is haemodynamically stable. Before starting the 14-day course of primaquine for radical cure, which investigation is mandatory?
- A G6PD enzyme assay ✓
- B Liver function tests
- C Blood urea and creatinine
- D Chest radiograph
Correct answer: A. G6PD enzyme assay
Explanation
Primaquine causes intravascular haemolysis in persons with glucose-6-phosphate dehydrogenase deficiency because its oxidative metabolites cannot be buffered in deficient red cells. National guidelines therefore require G6PD status to be known before the 14-day radical cure course of primaquine in vivax malaria. Liver and renal functions are useful baseline tests but they do not predict this specific adverse effect, so they are not mandatory before primaquine.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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