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Gametocyte Dynamics and the Role of Drugs in Reducing the Transmission Potential of Plasmodium vivax

Year: 2013
Type: review
Abstract: BACKGROUND: Designing interventions that will reduce transmission of vivax malaria requires knowledge of Plasmodium vivax gametocyte dynamics. METHODS: We analyzed data from a randomized controlled trial in northwestern Thailand and 2 trials in Papua, Indonesia, to identify and compare risk factors for vivax gametocytemia at enrollment and following treatment. RESULTS: A total of 492 patients with P. vivax infections from Thailand and 476 patients (162 with concurrent falciparum parasitemia) from Indonesia were evaluable. Also, 84.3% (415/492) and 66.6% (209/314) of patients with monoinfection were gametocytemic at enrollment, respectively. The ratio of gametocytemia to asexual parasitemia did not differ between acute and recurrent infections (P = .48 in Thailand, P = .08 in Indonesia). High asexual parasitemia was associated with an increased risk of gametocytemia during follow-up in both locations. In Thailand, the cumulative incidence of gametocytemia between day 7 and day 42 following dihydroartemisinin + piperaquine (DHA + PIP) was 6.92% vs 29.1% following chloroquine (P < .001). In Indonesia, the incidence of gametocytemia was 33.6% following artesunate + amodiaquine (AS + AQ), 7.42% following artemether + lumefantrine, and 6.80% following DHA + PIP (P < .001 for DHA + PIP vs AS + AQ). CONCLUSIONS: P. vivax gametocyte carriage mirrors asexual-stage infection. Prevention of relapses, particularly in those with high asexual parasitemia, is likely the most important strategy for interrupting P. vivax transmission.
DOI: 10.1093/infdis/jit261
Authors: Nicholas M. Douglas, Julie A. Simpson, Aung Pyae Phyo, Hadjar Siswantoro, Armedy R. Hasugian, Enny Kenangalem, Jeanne Rini Poespoprodjo, Pratap Singhasivanon, Nicholas M. Anstey, Nicholas J. White, Emiliana Tjitra, Francois Nosten, Ric N. Price
Institutions: Charles Darwin University, University of Oxford, Menzies School of Health Research, The University of Melbourne, Shoklo Malaria Research Unit, Mahidol University, Royal Darwin Hospital
Language: English
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $4,763
Funders: Wellcome Trust, Menzies School of Health Research, International Center for Responsible Gaming, University of Oxford, Australian Agency for International Development, Mahidol University, Medical Research Council, National Health and Medical Research Council
Awards: Research & Training to reduce morbidity & mortality from malaria in Papua ( Indonesia)& Papua New Guinea, Thailand Major Overseas Programme Core Grant Renewal 2010 to 2015., G5650507700, G6494912503, Improving the treatment of malaria., Optimising antimalarial combination therapies in an area coendemic for vivax and falciparum malaria, Improving the treatment of malaria., G893993069
OpenAlex ID: W2130622695
FWCI: 0.667
Cites: 54
Cited by: 61
Related to: 10