Update on pathogenesis, management, and control of Plasmodium vivax

Abstract

Purpose of reviewThis is a review of Plasmodium vivax epidemiology, pathogenesis, disease presentation, treatment and innovations in control and elimination. Here, we examine the recent literature and summarize new advances and ongoing challenges in the management of P. vivax. Recent findingsP. vivax has a complex life cycle in the human host which impacts disease severity and treatment regimens. There is increasing data for the presence of cryptic reservoirs in the spleen and bone marrow which may contribute to chronic vivax infections and possibly disease severity. Methods to map the geospatial epidemiology of P. vivax chloroquine resistance are advancing, and they will inform local treatment guidelines. P. vivax treatment requires an 8-aminoquinoline to eradicate the dormant liver stage. Evidence suggests that higher doses of 8-aminoquinolines may be needed for radical cure of tropical frequentrelapsing strains. Summary P. vivax is a significant global health problem. There have been recent developments in understanding the complexity of P. vivax biology and optimization of antimalarial therapy. Studies toward the development of best practices for P. vivax control and elimination programs are ongoing. Keywords 8-aminoquinoline, cryptic infection, glucose-6-phosphate dehydrogenase deficiency, P. vivax drug resistance, P. vivax prevention, P. vivax treatment, Plasmodium vivax, Plasmodium vivax circumsporozoite protein (PvCSP) vaccine development, radical cure P. vivax was estimated to cause 4.5 million (2%) of the 241 million cases of malaria in 2020 [2]. P. vivax is prevalent in the Middle East, Asia, the Western Pacific and Central and South America as well as in parts of Africa [1]. P. vivax accounted for 68.3% of malaria cases in the Americas, 36.3% of cases in Southeast Asia, 30.1% of cases in the Western Pacific, 18.1% of cases in the Eastern Mediterranean and 0.3% of cases in Africa in 2020 [2].P. vivax, like other Plasmodium species, is acquired from the bite of an infected female Anopheles mosquito. Sporozoites enter the bloodstream

A Pvs25 mRNA vaccine induces complete and durable transmission-blocking immunity to Plasmodium vivax

“…In many countries, P. vivax malaria is a major public health problem, causing severe illness and economic hardships in remote populations. A growing number of studies have indicated severity, complications, and deaths due to P. vivax malaria in pregnant women and small children 2 , 3 . Compared to Plasmodium falciparum -caused disease, P. vivax malaria is harder to control and eliminate due to its ability to lie dormant as a hypnozoite in the human liver for months to years before it reactivates 4 and cause a relapse of blood-stage infection.…”

Fused Enzyme Glucose-6-Phosphate Dehydrogenase::6-Phosphogluconolactonase (G6PD::6PGL) as a Potential Drug Target in Giardia lamblia, Trichomonas vaginalis, and Plasmodium falciparum

“…It is transmitted to humans through the bite of the female Anopheles mosquito. There are five species of parasites that can cause malaria in humans, but Plasmodium falciparum and Plasmodium vivax are the greatest threat ( Figure 1 ) [ 27 ]. While malaria is a preventable and curable disease, without prompt diagnosis and effective treatment, an uncomplicated case of malaria can progress to a severe form of the disease, often leading to a fatal outcome if left untreated.…”