title: Epidemiology of Plasmodium vivax Malaria in Peru.
abstract: Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s-2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005-2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine-primaquine for P. vivax Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination.
authors: Research Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.|Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: Angel
authors: A
authors: Rosas-Aguirre
authors: Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru.|Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: Dionicia
authors: D
authors: Gamboa
authors: Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: Paulo
authors: P
authors: Manrique
authors: Wadsworth Center, New York State Department of Health, Albany, New York.|Department of Biomedical Sciences, School of Public Health, University at Albany (State University of New York), Albany, New York.
authors: Jan E
authors: JE
authors: Conn
authors: Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California.
authors: Marta
authors: M
authors: Moreno
authors: Facultad de Salud Pública, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: Andres G
authors: AG
authors: Lescano
authors: Facultad de Salud Pública, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: Juan F
authors: JF
authors: Sanchez
authors: Dirección Regional de Salud Loreto, Ministerio de Salud, Iquitos, Peru.
authors: Hugo
authors: H
authors: Rodriguez
authors: Dirección Regional de Salud Loreto, Ministerio de Salud, Iquitos, Peru.
authors: Hermann
authors: H
authors: Silva
authors: Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: Alejandro
authors: A
authors: Llanos-Cuentas
authors: Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru.|Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru.|Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California.
authors: Joseph M
authors: JM
authors: Vinetz
mesh_terms: D000818:Animals; D000852:Anopheles / Q000469:parasitology / Q000502:physiology; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D019353:Endemic Diseases; D006801:Humans; D015994:Incidence; D007303:Insect Vectors; D016780:Malaria, Vivax / Q000453:epidemiology*; D010568:Peru / Q000453:epidemiology; D000071184:Pharmacogenomic Variants; D010966:Plasmodium vivax / Q000235:genetics; D011634:Public Health; D013997:Time Factors
chemical_list: D000962:Antimalarials