title: Implications of Plasmodium vivax Biology for Control, Elimination, and Research.
abstract: This paper summarizes our current understanding of the biology of Plasmodium vivax, how it differs from Plasmodium falciparum, and how these differences explain the need for P. vivax-tailored interventions. The article further pinpoints knowledge gaps where investments in research are needed to help identify and develop such specific interventions. The principal obstacles to reduce and eventually eliminate P. vivax reside in 1) its higher vectorial capacity compared with P. falciparum due to its ability to develop at lower temperature and over a shorter sporogonic cycle in the vector, allowing transmission in temperate zones and making it less sensitive to vector control measures that are otherwise effective on P. falciparum; 2) the presence of dormant liver forms (hypnozoites), sustaining multiple relapsing episodes from a single infectious bite that cannot be diagnosed and are not susceptible to any available antimalarial except primaquine, with routine deployment restricted by toxicity; 3) low parasite densities, which are difficult to detect with current diagnostics leading to missed diagnoses and delayed treatments (and protracted transmission), coupled with 4) transmission stages (gametocytes) occurring early in acute infections, before infection is diagnosed.
authors: Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.|UNICEF/UNDP/World Bank/WHO Special Programme on Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
authors: Piero L
authors: PL
authors: Olliaro
authors: Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: John W
authors: JW
authors: Barnwell
authors: Department of Medical Biology, University of Melbourne, Melbourne, Australia.|Division of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.
authors: Alyssa
authors: A
authors: Barry
authors: Independent Consultant, Colombo 5. Sri Lanka.
authors: Kamini
authors: K
authors: Mendis
authors: Institute of Global Health (ISGLOBAL), Barcelona, Spain.|Division of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.
authors: Ivo
authors: I
authors: Mueller
authors: UNICEF/UNDP/World Bank/WHO Special Programme on Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
authors: John C
authors: JC
authors: Reeder
authors: School of Population Health, University of Queensland, Brisbane, Australia.
authors: G Dennis
authors: GD
authors: Shanks
authors: Centre d'Immunologie et de Maladies Infectieuses (CIMI)-Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) U1135-Centre National de la Recherche Scientifique (CNRS) ERL 8255, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UPMC UMRS CR7, Paris, France.
authors: Georges
authors: G
authors: Snounou
authors: Independent Scholar, Bangkok, Thailand.
authors: Chansuda
authors: C
authors: Wongsrichanalai
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D014644:Genetic Variation; D014943:Global Health; D006801:Humans; D008018:Life Cycle Stages; D016780:Malaria, Vivax / Q000469:parasitology* / Q000517:prevention & control / Q000635:transmission; D010966:Plasmodium vivax / Q000235:genetics / Q000502:physiology*; D013045:Species Specificity
chemical_list: D000962:Antimalarials