title: Global Epidemiology of Plasmodium vivax.
abstract: Plasmodium vivax is the most widespread human malaria, putting 2.5 billion people at risk of infection. Its unique biological and epidemiological characteristics pose challenges to control strategies that have been principally targeted against Plasmodium falciparum Unlike P. falciparum, P. vivax infections have typically low blood-stage parasitemia with gametocytes emerging before illness manifests, and dormant liver stages causing relapses. These traits affect both its geographic distribution and transmission patterns. Asymptomatic infections, high-risk groups, and resulting case burdens are described in this review. Despite relatively low prevalence measurements and parasitemia levels, along with high proportions of asymptomatic cases, this parasite is not benign. Plasmodium vivax can be associated with severe and even fatal illness. Spreading resistance to chloroquine against the acute attack, and the operational inadequacy of primaquine against the multiple attacks of relapse, exacerbates the risk of poor outcomes among the tens of millions suffering from infection each year. Without strategies accounting for these P. vivax-specific characteristics, progress toward elimination of endemic malaria transmission will be substantially impeded.
authors.affiliation: Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio.|Spatial Ecology and Epidemiology Group, Department of Zoology, University of Oxford, Oxford, United Kingdom.
authors.forename: Rosalind E
authors.initials: RE
authors.lastname: Howes
authors.affiliation: Spatial Ecology and Epidemiology Group, Department of Zoology, University of Oxford, Oxford, United Kingdom.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Battle
authors.affiliation: Global Malaria Program, World Health Organization, Geneva, Switzerland.
authors.forename: Kamini N
authors.initials: KN
authors.lastname: Mendis
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.|Sanaria Institute for Global Health and Tropical Medicine, Rockville, Maryland.|Fogarty International Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: David L
authors.initials: DL
authors.lastname: Smith
authors.affiliation: Global Malaria Program, World Health Organization, Geneva, Switzerland.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Cibulskis
authors.affiliation: Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.|Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Baird
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, Maryland.|Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, United Kingdom.|Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.
authors.forename: Simon I
authors.initials: SI
authors.lastname: Hay
mesh_terms: D014943:Global Health; D006801:Humans; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000469:parasitology; D010966:Plasmodium vivax / Q000502:physiology*