Key Knowledge Gaps for Plasmodium vivax Control and Elimination.

Quique Bassat,Chansuda Wongsrichanalai,Toby Leslie,Mar Velarde,Jessica Lin,J. Kevin Baird,Ivo Mueller

doi:10.4269/ajtmh.16-0180

Abstract

There is inadequate understanding of the biology, pathology, transmission, and control of Plasmodium vivax, the geographically most widespread cause of human malaria. During the last decades, study of this species was neglected, in part due to the erroneous belief that it is intrinsically benign. In addition, many technical challenges in culturing the parasite also hampered understanding its fundamental biology and molecular and cellular responses to chemotherapeutics. Research on vivax malaria needs to be substantially expanded over the next decade to accelerate its elimination and eradication. This article summarizes key knowledge gaps identified by researchers, national malaria control programs, and other stakeholders assembled by the World Health Organization to develop strategies for controlling and eliminating vivax malaria. The priorities presented in this article emerged in these technical discussions, and were adopted by expert consensus of the authors. All involved understood the priority placed upon pragmatism in this research agenda, that is, focus upon tools delivering better prevention, diagnosis, treatment, and surveillance of P. vivax.

Highlights

Plasmodium vivax is the most geographically widespread malaria parasite species and codominates with Plasmodium falciparum as a cause of human malaria
Despite long being regarded as benign, evidence shows that P. vivax is very often associated with severe, life-threatening, and fatal malaria in patients from endemic areas as well as in travelers.[2]
Where control programs have been intensified in coendemic areas, P. vivax tends to be more resilient than P. falciparum.[3,4,5]

Summary

Introduction

Plasmodium vivax is the most geographically widespread malaria parasite species and codominates with Plasmodium falciparum as a cause of human malaria. Plasmodium vivax infects tens of millions of people each year.[1] Despite long being regarded as benign, evidence shows that P. vivax is very often associated with severe, life-threatening, and fatal malaria in patients from endemic areas as well as in travelers.[2]. Where control programs have been intensified in coendemic areas, P. vivax tends to be more resilient than P. falciparum.[3,4,5] This is due to biological features unique to P. vivax enhancing its ability to survive in conditions unsuited to P. falciparum and propagate further transmission.[6] The conventional methods of control historically aimed solely at P. falciparum may not suffice. Interventions and strategies aimed at P. vivax would greatly accelerate progress against it.[7]

Objectives

Findings

Conclusion