title: The burden of Plasmodium vivax relapses in an Amerindian village in French Guiana.
abstract: Malaria is a public health problem in French Guiana. Plasmodium vivax is the most frequent parasite. The objective of this analysis was to estimate the proportion of relapses in the burden of vivax malaria using the statistical rule stating that any case of vivax malaria occurring less than 90 days following a first episode is a relapse.A total of 622 subjects were followed for 2,9 years with 336 first single episodes of P. vivax malaria, and a total of 1,226 episodes of vivax malaria among which 559 were relapses (45.5%). For 194 patients having had falciparum malaria followed by vivax malaria it was estimated that 19% of the vivax episodes occurred less than 90 days following the falciparum episode and thus were possibly relapses due to the activation of latent hypnozoites. Despite the number of vivax cases and the number of relapses, there were only 28 recorded primaquine prescriptions (3.4% of vivax episodes, 4.5% of subjects).The present study points out that despite the fact that nearly half of the P. vivax cases, many of which in children, are caused by latent hypnozoites, only a minority of them benefit from primaquine radical cure. The obstacles to this are discussed and suggestions are made to reduce the burden of vivax malaria in Camopi and other remote health centres in French Guiana.
authors.affiliation: Centre d'Investigation Clinique Epidémiologie clinique Antilles Guyane (Inserm / DGOS CIE 802), Centre Hospitalier de Cayenne, Cayenne, French Guiana. mathieu.nacher66@gmail.com.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
authors.forename: Aurelia
authors.initials: A
authors.lastname: Stefani
authors.forename: Celia
authors.initials: C
authors.lastname: Basurko
authors.forename: Delphine
authors.initials: D
authors.lastname: Lemonnier
authors.forename: Félix
authors.initials: F
authors.lastname: Djossou
authors.forename: Magalie
authors.initials: M
authors.lastname: Demar
authors.forename: Narcisse
authors.initials: N
authors.lastname: Elenga
authors.forename: Paul
authors.initials: P
authors.lastname: Brousse
authors.forename: Muriel
authors.initials: M
authors.lastname: Ville
authors.forename: Bernard
authors.initials: B
authors.lastname: Carme
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005616:French Guiana / Q000453:epidemiology; D006801:Humans; D007199:Indians, South American; D007223:Infant; D007231:Infant, Newborn; D016780:Malaria, Vivax / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D010966:Plasmodium vivax / Q000302:isolation & purification*; D011319:Primaquine / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D000962:Antimalarials; D011319:Primaquine