In conclusion:

- From a patient perspective, high-dose PQ and TQ is warranted
- From a community perspective, low-dose and high-dose drug regimens will cause similar reductions in P. vivax transmission

Ensuring high drug safety, adherence and coverage is key to maximising PQ and TQ impact.

We quantified the community-level impact of routinely treating symptomatic P. vivax cases with PQ or TQ using an existing agent-based model.

- All regimens can achieve a similar impact
- Drug adherence and eligibility criteria hamper impact
- Impact decreases with increasing transmission intensity

We estimated the patient-level efficacy of PQ and TQ by calibrating a novel mathematical model to clinical trial data.

- Effective treatment can eliminate almost all P. vivax hypnozoites
- PQ and TQ regimens have differing efficacies

Unlike the more common P. falciparum, P. vivax forms dormant liver stage parasites (hypnozoites) that can reactivate weeks to months after primary infection to cause recurrent infections.

The efficacy of liver-stage drugs PQ and TQ cannot be estimated directly because hypnozoites are undetectable.