Plasmodium falciparum gametocyte carriage is associated with subsequent Plasmodium vivax relapse after treatment.
Jessica T. Lin,Delia Bethell,Stuart D. Tyner,Chanthap Lon,Naman K. Shah,David L. Saunders,Sabaithip Sriwichai,Phisit Khemawoot,Worachet Kuntawunggin,Bryan Smith,Harald Noedl,Kurt Schaecher,Duong Socheat,Youry Se,Steven R. Meshnick,Mark M Fukuda +15 more
TLDR
The findings suggest that the majority of vivax infections arising after treatment of falciparum malaria originate from relapsing liver-stage parasites, which may benefit from empiric treatment with an 8-aminoquinolone such as primaquine.Abstract:
Mixed P. falciparum/P. vivax infections are common in southeast Asia. When patients with P. falciparum malaria are treated and followed for several weeks, a significant proportion will develop P. vivax malaria. In a combined analysis of 243 patients recruited to two malaria treatment trials in western Cambodia, 20/43 (47%) of those with P. falciparum gametocytes on admission developed P. vivax malaria by Day 28 of follow-up. The presence of Pf gametocytes on an initial blood smear was associated with a 3.5-fold greater rate of vivax parasitemia post-treatment (IRR = 3.5, 95% CI 2.0–6.0, p<0.001). The increased rate of post-treatment P. vivax infection persisted when correlates of exposure and immunity such as a history of malaria, male gender, and age were controlled for (IRR = 3.0, 95% CI 1.9–4.7, p<0.001). Polymerase chain reaction (PCR) confirmed that only a low proportion of subjects (5/55 or 9.1%) who developed vivax during follow-up had detectable Pv parasites in the peripheral blood at baseline. Molecular detection of falciparum gametocytes by reverse transcriptase PCR in a subset of patients strengthened the observed association, while PCR detection of Pv parasitemia at follow-up was similar to microscopy results. These findings suggest that the majority of vivax infections arising after treatment of falciparum malaria originate from relapsing liver-stage parasites. In settings such as western Cambodia, the presence of both sexual and asexual forms of P. falciparum on blood smear at presentation with acute falciparum malaria serves as a marker for possible occult P. vivax coinfection and subsequent relapse. These patients may benefit from empiric treatment with an 8-aminoquinolone such as primaquine.read more
Citations
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Journal ArticleDOI
Primaquine in vivax malaria: an update and review on management issues
TL;DR: This update and review focuses on five major aspects of primaquine use in treatment of vivax malaria, namely: evidence of efficacy of Primaquine for its current indications, potential hazards of its widespread use, critical analysis of reported resistance against primaquines containing regimens, and the potential for replacement of primquine with newer drugs.
Journal ArticleDOI
Microscopic Plasmodium falciparum Gametocytemia and Infectivity to Mosquitoes in Cambodia
Jessica T. Lin,Ratawan Ubalee,Chanthap Lon,Sujata Balasubramanian,Worachet Kuntawunginn,Rifat Rahman,Piyaporn Saingam,Thay Kheang Heng,Dav Vy,Savoeun San,Sarath Nuom,Hana Burkly,Nitima Chanarat,Chanudom Ponsa,Lauren Levitz,Christian M. Parobek,Char Meng Chuor,Sok Somethy,Michele D. Spring,Charlotte A. Lanteri,Panita Gosi,Steven R. Meshnick,David L. Saunders +22 more
TL;DR: In low-transmission settings, targeting transmission-blocking interventions to those with microscopic gametocytemia may have an outsized effect on malaria control and elimination.
Journal ArticleDOI
Monitoring antimalarial drug resistance in India via sentinel sites: outcomes and risk factors for treatment failure, 2009–2010
Neelima Mishra,Jai Prakash Narayan Singh,Bina Srivastava,Usha Arora,Naman K. Shah,S. K. Ghosh,Rajendra M Bhatt,S. K. Sharma,M Das,Ashwani Kumar,Anupkumar R. Anvikar,Kamlesh Kaitholia,Ruchi Gupta,G S Sonal,A. C. Dhariwal,Neena Valecha +15 more
TL;DR: The first-line antimalarials used in the country remain safe and efficacious and the relative benefits of age- and weight-based dosing need further exploration.
Journal ArticleDOI
Serologic markers in relation to parasite exposure history help to estimate transmission dynamics of Plasmodium vivax.
Fadile Yildiz Zeyrek,Fadile Yildiz Zeyrek,Nirianne Marie Q. Palacpac,Fehmi Yüksel,Masanori Yagi,Kaori Honjo,Yukiko Fujita,Nobuko Arisue,Satoru Takeo,Kazuyuki Tanabe,Toshihiro Horii,Takafumi Tsuboi,Ken Ishii,Cevayir Coban +13 more
TL;DR: A sero-immunological study evaluating antibody responses of individuals living in Sanliurfa to four different P. vivax antigens suggests that a prior history of malaria infection and age can be determining factors for the levels and sustainability of naturally acquired antibodies.
Journal ArticleDOI
Single dose primaquine to reduce gametocyte carriage and Plasmodium falciparum transmission in Cambodia: An open-label randomized trial.
Jessica T. Lin,Chanthap Lon,Michele D. Spring,Somethy Sok,Soklyda Chann,Mali Ittiverakul,Worachet Kuntawunginn,Mok My,Kheangheng Thay,Rifat Rahman,Sujata Balasubramanian,Mengchuor Char,Charlotte A. Lanteri,Panita Gosi,Ratawan Ubalee,Steven R. Meshnick,David L. Saunders +16 more
TL;DR: In a setting of established ACT resistance, a single dose of 45mg primaquine added to DHP rapidly and significantly reduced gametocytemia, while DHP-alone failed to reduce gametocytetemia and prevent malaria transmission to mosquitoes.
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