G6PD and G6PD deficiency: Adverse events associated with primaquine use, especially hemolysis, are of greater concern55 as they can lead to severe complications.48 An autopsy series of P. vivax patients found severe primaquine-induced hemolysis and associated complications as the main cause of death in two individuals.42 The lack of laboratory facilities and tests for G6PD status assessment in the field certainly leads to G6PD deficiency underdiagnosis and underreporting.