P vivax treatment options.

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Who reccommendations for P vivax treatment (https://apps.who.int/iris/bitstream/handle/10665/162441/9789241549127_eng.pdf) are for:

Uncomplicated
In areas with chloroquine-susceptible infections, treat adults and children with uncomplicated P. vivax, P. ovale, P. malariae or P. knowlesi malaria with either an ACT (except pregnant women in their first trimester) or chloroquine. In areas with chloroquine-resistant infections, treat adults and children with uncomplicated P. vivax, P. ovale, P. malariae or P. knowlesi malaria (except pregnant women in their first trimester) with an ACT.

Preventing relapse
The G6PD status of patients should be used to guide administration of primaquine for preventing relapse. To prevent relapse, treat P. vivax or P. ovale malaria in children and adults (except pregnant women, infants aged < 6 months, women breastfeeding
infants aged < 6 months, women breastfeeding older infants unless they are known no to be G6PD deficient, and people with G6PD deficiency) with a 14-day course (0.25-0.5 mg/kg bw daily) of primaquine in all transmission settings. In people with G6PD deficiency, consider preventing relapse by giving primaquine base at 0.75 mg/kg bw once a week for 8 weeks, with close medical supervision
for potential primaquine-induced adverse haematological effects. When the G6PD status is unknown and G6PD testing is not available, a decision to prescribe primaquine must be based on an assessment of the risks and benefits of adding primaquine.

To model this we would need to:

• Include a hypnozoite-clearing drug option (primaquine)
• Include a G6PD status variable for individuals

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Can refer to the Intervention models: treatment section of White et al (2018) for more detailed information on possible treatment implementation.