title: Microgeographical differences of Plasmodium vivax relapse and re-infection in the Peruvian Amazon.
abstract: To determine the magnitude of Plasmodium vivax relapsing malaria in rural Amazonia, we carried out a study in four sites in northeastern Peru. Polymerase chain reaction-restriction fragment length polymorphism of PvMSP-3α and tandem repeat (TR) markers were compared for their ability to distinguish relapse versus reinfection. Of 1,507 subjects with P. vivax malaria, 354 developed > 1 episode during the study; 97 of 354 (27.5%) were defined as relapse using Pvmsp-3α alone. The addition of TR polymorphism analysis significantly reduced the number of definitively defined relapses to 26 of 354 (7.4%) (P < 0.05). Multivariate logistic regression modeling showed that the probability of having > 1 infection was associated with the following: subjects in Mazan (odds ratio [OR] = 2.56; 95% confidence interval [CI] 1.87, 3.51), 15-44 years of age (OR = 1.49; 95% CI 1.03, 2.15), traveling for job purposes (OR = 1.45; 95%CI 1.03, 2.06), and travel within past month (OR = 1.46; 95% CI 1.0, 2.14). The high discriminatory capacity of the molecular tools shown here is useful for understanding the micro-geography of malaria transmission.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of California San Diego, La Jolla, California 92093-0741, USA.
authors.forename: Raul
authors.initials: R
authors.lastname: Chuquiyauri
authors.forename: Pablo
authors.initials: P
authors.lastname: Peñataro
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
authors.forename: Manuel
authors.initials: M
authors.lastname: Fasabi
authors.forename: Maritza
authors.initials: M
authors.lastname: Calderon
authors.forename: Sonia
authors.initials: S
authors.lastname: Torres
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.forename: Margaret
authors.initials: M
authors.lastname: Kosek
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Vinetz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016054:DNA, Protozoan / Q000097:blood; D005260:Female; D005819:Genetic Markers; D005838:Genotype; D006801:Humans; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010568:Peru / Q000453:epidemiology; D010966:Plasmodium vivax / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D012150:Polymorphism, Restriction Fragment Length; D015800:Protozoan Proteins / Q000235:genetics; D012008:Recurrence; D013997:Time Factors
chemical_list: D016054:DNA, Protozoan; D005819:Genetic Markers; D015800:Protozoan Proteins