Management of acute haemolysis (low dose primaquine)

Haemolysis in acute malaria is inevitable, the mean haemoglobin concentration usually falling within the first week, with recovery usually taking 28-42 days. Primaquine can cause additional haemolysis particularly in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, therefore clinical staff need to be vigilant for the signs and symptoms of haemolysis and the risk of trial subjects becoming anaemic. This procedure describes a simplified process for field site staff to identify and manage any cases of suspected acute haemolysis in a clinical trial (such as trials involving low-dose primaquine).