Before starting treatment with primaquine, what test should be conducted?

Before initiating treatment with primaquine, it is essential to conduct a G6PD deficiency test. This is crucial because primaquine, an antimalarial medication used to treat and prevent malaria, can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. G6PD is an enzyme that helps protect red blood cells from oxidative stress, and those who are deficient in this enzyme are at a significantly heightened risk of red blood cell breakdown when exposed to oxidative drugs, including primaquine.

Conducting the G6PD deficiency test prior to treatment ensures that patients at risk are identified, preventing potential complications associated with hemolysis. If a patient is found to be G6PD deficient, alternative treatment options for malaria that do not pose the same risk can be considered.

Other tests such as vitamin D levels, liver function tests, or thyroid function tests are not directly relevant to the safe administration of primaquine. While liver function is generally important in the context of many medications, in this specific case, the primary concern is the potential for hemolysis in G6PD-deficient individuals.