Epidemiology of Plasmodium vivax Malaria in India

Abstract

Historically, malaria in India was predominantly caused by Plasmodium vivax, accounting for 53% of the estimated cases. After the spread of drug-resistant Plasmodium falciparum in the 1990s, the prevalence of the two species remained equivalent at the national level for a decade. By 2014, the proportion of P. vivax has decreased to 34% nationally, but with high regional variation. In 2014, P. vivax accounted for around 380,000 malaria cases in India; almost a sixth of all P. vivax cases reported globally. Plasmodium vivax has remained resistant to control measures, particularly in urban areas. Urban malaria is predominantly caused by P. vivax and is subject to outbreaks, often associated with increased mortality, and triggered by bursts of migration and construction. The epidemiology of P. vivax varies substantially within India, including multiple relapse phenotypes with varying latencies between primary infection and relapse. Moreover, the hypnozoite reservoir maintains transmission potential and enables reestablishment of the parasite in areas in which it was thought eradicated. The burden of malaria in India is complex because of the highly variable malaria eco-epidemiological profiles, transmission factors, and the presence of multiple Plasmodium species and Anopheles vectors. This review of P. vivax malaria in India describes epidemiological trends with particular attention to four states: Gujarat, Karnataka, Haryana, and Odisha.

Vivax infection alters peripheral B‐cell profile and induces persistent serum IgM

“…In 2016, P. vivax was estimated to have been responsible for 8.5 million malaria cases globally . In 2014, particularly in urban India, 98% of all reported malaria cases were due to P. vivax . Infections by P. vivax were generally considered to be benign and self‐limiting.…”

“…6 In 2014, particularly in urban India, 98% of all reported malaria cases were due to P. vivax. 7 Infections by P. vivax were generally considered to be benign and self-limiting. However, recent reports indicate that P. vivax infections may lead to severe manifestations, including multiorgan dysfunction, cerebral malaria and acute thrombocytopenia.…”

Response to fever and utilization of standby emergency treatment (SBET) for malaria in travellers to Southeast Asia: a questionnaire-based cohort study

“…India also recorded a decline in malaria cases, but predominantly through control of falciparum malaria. In contrast, the relative proportion of Plasmodium vivax cases was increasing on the Indian sub-continent [10]. …”

Clinical profile and geographical distribution of malaria patients attending a tertiary care centre in Mangaluru, South India

“…12 P. vivax infection has always been shown to have higher prevalence and has accounted for 98% of all malaria cases within urban malaria scheme in India in the year 2014. 13 Complications are frequently associated with malaria. According to our data thrombocytopenia was the most common complication with incidence if 18.6%.…”