Assessment of the Adherence of Primaquine for the Control and Elimination of Malaria in Senegal

Primaquine is a drug widely used for Plasmodium vivax malaria treatment. It is known to be active on Plasmodium falciparum mature gametocytes which are responsible for the transmission of the parasite from humans to mosquitoes. In 2018, Senegal initiated the large-scale use of a single low dose of primaquine associated with artemisinin-based combination therapy for malaria elimination. This study aimed to assess the therapeutic adherence of the implementation of primaquine in the Saint-Louis region. To measure therapeutic adherence, questionnaires were developed and made it possible to collect information from treated malaria patients, health workers, the investigating team and health authorities. Out of 1087 malaria patients, 585 received primaquine. Children under the age of 5 could not receive it due to the lack of the pediatric formulation. The involvement of private health facilities has shown its effectiveness in the implementation of the strategy. However, efforts must be made to improve the documentation of cases in the national surveillance system and to acquire logistical means facilitating the supply of the drug in remote locations. The authorities must become more involved in finding a solution for the availability and sufficient supply of primaquine to formulations adapted to the population.