Plasmodium vivax transmission: chances for control?

doi:10.1016/j.pt.2004.02.001

Trends in Parasitology

Volume 20, Issue 4, 1 April 2004, Pages 192-198

https://doi.org/10.1016/j.pt.2004.02.001 Get rights and content

Abstract

Plasmodium vivax is a growing public health problem in many regions of the world as a result of re-emergence and increased transmission. This article reviews the unique biology related to P. vivax transmission and addresses potential problems associated with the control of this parasite, which depends on an in-depth knowledge of malaria transmission. The success of comprehensive control measures will require advanced laboratory and field research on this parasite, international awareness of the problem, and co-operation by members of the international malaria community to implement new knowledge and improve the management of transmission in each endemic area.

Section snippets

Liver or exo-erythrocytic stages

A unique characteristic of P. vivax and Plasmodium ovale is the generation of dormant hypnozoites in the liver that are responsible for relapses. However, our knowledge of the biology of Plasmodium liver or exo-erythrocytic (EE) stages is far more scarce than that of the blood stages. In general, studies on Plasmodium EE stages have focused on in vivo and in vitro development of the parasites, molecular mechanisms of sporozoite–hepatocyte interactions during the sporozoite invasion phase, and

Potential problems with drug resistance

In recent years, the alarmingly rapid increase of multiple drug-resistance (MDR) P. falciparum strains has been a major concern for the future control of malaria and has been the focus of many malariologists [12]. By contrast, research on drug resistance in P. vivax has lagged behind. Many drug-resistant P. falciparum strains have originated in Southeast Asia. In Thailand, MDR P. falciparum strains are notably prevalent on the Thai–Cambodian and Thai–Myanmar borders. The antimalarial drug

Changes in P. vivax prevalence

The re-emergence of P. vivax in many malaria-endemic areas where the disease was eradicated many years ago has now become a major problem, such as in China and Korea 37, 38. In the USA, malaria transmission was eliminated by the late 1960s [39] (see: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00042732.htm), but sporadic cases of locally acquired mosquito-transmitted malaria continue to occur. For instance, transmission of P. vivax in Virginia in 2002 illustrates the re-introduction of P. vivax

Vector control with chemical insecticides

A thorough knowledge of mosquito vectors is essential to understanding the epidemiology of P. vivax transmission, and hence planning and implementing effective vector control programs 51, 52, 53. Usually, control strategies must cope with a complex vector system, which includes a few primary vectors and several secondary vectors, whose impact on transmission varies depending on the region. In Southeast Asia, the main primary vectors, for example, An. dirus s.l. and An. minimus s.l., are

Transmission-blocking vaccines

Transmission-blocking vaccines (TBVs) are being developed to interrupt malaria transmission in the mosquito vector. TBV candidates are surface molecules expressed from gametes to ookinetes, which include the gamete and early zygote surface proteins Ps48/45 and Ps230, and the late zygote and ookinete surface proteins Ps25 and Ps28 [61]. TBVs target the sexual stages of the malaria parasite as they are ingested in a bloodmeal by a mosquito, therefore low levels of antigenic polymorphisms are

Chances for control?

The unexpected re-emergence of P. vivax in many areas following a series of successful eradication programs serves as an important lesson in the history of failed malaria control programs 40, 41, 42. These reports raise questions of how efficient malaria control programs are and to what extent successful control of P. vivax transmission can be achieved. A recent report of successful eradication of P. vivax on Aneityum, a Vanuatu island with a small number of inhabitants, is promising [64].

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Plasmodium vivax – How hidden reservoirs hinder global malaria elimination
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Plasmodium vivax is the most geographically widespread human malaria parasite. Global malaria efforts have been less successful at reducing the burden of P. vivax compared to P. falciparum, owing to the unique biology and related treatment complexity of P. vivax. As a result, P. vivax is now the dominant malaria parasite throughout the Asia-Pacific and South America causing up to 14 million clinical cases every year and is considered a major obstacle to malaria elimination. Key features circumventing existing malaria control tools are the transmissibility of asymptomatic, low-density circulating infections and reservoirs of persistent dormant liver stages (hypnozoites) that are undetectable but reactivate to cause relapsing infections and sustain transmission. In this review we summarise the new knowledge shaping our understanding of the global epidemiology of P. vivax infections, highlighting the challenges for elimination and the tools that will be required achieve this.
Serology for Plasmodium vivax surveillance: A novel approach to accelerate towards elimination
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Citation Excerpt :
However, the reduction rate of P. falciparum prevalence has plateaued since 2014 and since 2012 for P. vivax [2]. In areas where P. falciparum and P. vivax are co-endemic, there is evidence that the proportion of cases due to P. vivax increases as the overall number of malaria infections decreases (as reviewed in other papers [3–6]). This highlights that novel approaches, including for surveillance, are required to specifically target P. vivax parasites.
Plasmodium vivax is the most widespread causative agent of human malaria in the world. Despite the ongoing implementation of malaria control programs, the rate of case reduction has declined over the last 5 years. Hence, surveillance of malaria transmission should be in place to identify and monitor areas that require intensified malaria control interventions. Serological tools may offer additional insights into transmission intensity over parasite and entomological measures, especially as transmission levels decline. Antibodies can be detected in the host system for months to even years after parasite infections have been cleared from the blood, enabling malaria exposure history to be captured. Because the Plasmodium parasite expresses more than 5000 proteins, it is important to a) understand antibody longevity following infection and b) measure antibodies to more than one antigen in order to accurately inform on the exposure and/or immune status of populations. This review summarises current practices for surveillance of P. vivax malaria, the current state of research into serological exposure markers and their potential role for accelerating malaria elimination, and discusses further studies that need to be undertaken to see such technology implemented in malaria-endemic areas.
Plasmodium vivax in the Era of the Shrinking P. falciparum Map
2020, Trends in Parasitology
Citation Excerpt :
Over the past decade, enhanced malaria-control activities, supported by increased funding for malaria-elimination activities, have led to a substantial decrease in the incidence of malaria in many malaria-endemic countries [32]. However, there has been a consistent increase in the proportion of malaria due to P. vivax (Figure 4) [13,33–35]. This increase is likely due to multiple factors, including reporting practices, the ability to detect and treat infected individuals effectively, greater resilience of P. vivax to standard malaria-control measures, and the parasite’s transmission dynamics (Table 1).
Plasmodium vivax is an important cause of malaria, associated with a significant public health burden. Whilst enhanced malaria-control activities have successfully reduced the incidence of Plasmodium falciparum malaria in many areas, there has been a consistent increase in the proportion of malaria due to P. vivax in regions where both parasites coexist. This article reviews the epidemiology and biology of P. vivax, how the parasite differs from P. falciparum, and the key features that render it more difficult to control and eliminate. Since transmission of the parasite is driven largely by relapses from dormant liver stages, its timely elimination will require widespread access to safe and effective radical cure.
Transcriptome and histone epigenome of Plasmodium vivax salivary-gland sporozoites point to tight regulatory control and mechanisms for liver-stage differentiation in relapsing malaria
2019, International Journal for Parasitology
Plasmodium vivax is the key obstacle to malaria elimination in Asia and Latin America, largely attributed to its ability to form resilient hypnozoites (sleeper cells) in the host liver that escape treatment and cause relapsing infections. The decision to form hypnozoites is made early in the liver infection and may already be set in sporozoites prior to invasion. To better understand these early stages of infection, we undertook a comprehensive transcriptomic and histone epigenetic characterization of P. vivax sporozoites. Through comparisons with recently published proteomic data for the P. vivax sporozoite, our study found that although highly transcribed, transcripts associated with functions needed for early infection of the vertebrate host are not detectable as proteins and may be regulated through translational repression. We identified differential transcription between the sporozoite and published transcriptomes of asexual blood stages and mixed versus hypnozoite-enriched liver stages. These comparisons point to multiple layers of transcriptional, post-transcriptional and post-translational control that appear active in sporozoites and to a lesser extent hypnozoites, but are largely absent in replicating liver schizonts or mixed blood stages. We also characterised histone epigenetic modifications in the P. vivax sporozoite and explored their role in regulating transcription. Collectively, these data support the hypothesis that the sporozoite is a tightly programmed stage to infect the human host and identify mechanisms for hypnozoite formation that may be further explored in liver stage models.
Genetic diversity of the Plasmodium vivax phosphatidylinositol 3-kinase gene in two regions of the China-Myanmar border
2018, Infection, Genetics and Evolution
Artemisinin resistance in Plasmodium falciparum was associated with mutations in the propeller domain of the PfK13 gene and increased phosphatidylinositol-3′-kinase (PfPI3K) activity. Assessment of the genetic diversity of the PfK13 ortholog PvK12 in Plasmodium vivax field samples from the same hotspots of P. falciparum artemisinin resistance revealed a limited genetic diversity of PvK12. Following the same logic, we analyzed genetic variations of the PvPI3K gene in 188 P. vivax field isolates from two geographic locations along the China-Myanmar border. Overall, high genetic diversity of PvPI3K was observed; parasites from Yunnan's Tengchong County had higher genetic diversity than those from Laiza Township, Kachin State, Myanmar. Almost all the neutrality tests applied detected statistically significant deviation from zero. The negative Tajima's D values in both populations implicated that PvPI3K gene might have experienced either a directional selection or an expansion in population size. There was low linkage disequilibrium between the PvPI3K mutations in both populations, suggesting the existence of large, almost panmictic, parasite populations that enabled effective recombination. This later result was confirmed by the detection of a minimum of five recombination events in each population with two major breakpoints. Multiple tests for selection confirmed a signature of purifying selection on PvPI3K. All the amino acid mutations were predicted to be neutral for the PI3K protein's function. These findings provide insights on the genetic diversity of P. vivax populations along the China-Myanmar border.
Population genomic evidence of structured and connected Plasmodium vivax populations under host selection in Latin America
2024, Ecology and Evolution

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Trends in Parasitology

Vivax series:Plasmodium vivax transmission: chances for control?

Abstract

Section snippets

Liver or exo-erythrocytic stages

Potential problems with drug resistance

Changes in P. vivax prevalence

Vector control with chemical insecticides

Transmission-blocking vaccines

Chances for control?

Trans. R. Soc. Trop. Med. Hyg.

Trends Parasitol.

Lancet Infect. Dis.

Drug Resistance Updates

Mol. Biochem. Parasitol.

Lancet

Curr. Opin. Microbiol.

Trans. R. Soc. Trop. Med. Hyg.

Trans. R. Soc. Trop. Med. Hyg.

Trends Parasitol.

Acta Trop.

Trans. R. Soc. Trop. Med. Hyg.

Trans. R. Soc. Trop. Med. Hyg.

Acta Trop.

Trans. R. Soc. Trop. Med. Hyg.

Trans. R. Soc. Trop. Med. Hyg.

Mol. Biochem. Parasitol.

Mol. Biochem. Parasitol.

Lancet

Trends Parasitol.

Parasitol. Int.

Curr. Opin. Microbiol.

The neglected burden of Plasmodium vivax malaria

Am. J. Trop. Med. Hyg.

Cerebral involvement in benign tertian malaria

Am. J. Trop. Med. Hyg.

Plasmodium falciparum and P. vivax circumsporozoite proteins in anophelines (Diptera: Culicidae) collected in eastern Thailand

J. Med. Entomol.

Estimation of vectorial capacity of Anopheles dirus Diptera: Culicidae) in a forest-fringed village of Assam (India)

Vector Borne Zoonotic Dis.

Hepatocyte CD81 is required for Plasmodium falciparum and Plasmodium yoelii sporozoite infectivity

Nat. Med.

Proteoglycans mediate malaria sporozoite targeting to the liver

Mol. Microbiol.

Migration through host cells activates Plasmodium sporozoite for infection

Nat. Med.

A liver stage-specific antigen of Plasmodium falciparum characterized by gene cloning

Nature

Protection against Plasmodium falciparum malaria in chimpanzees by immunization with the conserved pre-erythrocytic liver-stage antigen 3

Nat. Med.

Pyrimethamine resistance in Plasmodium vivax malaria

Bull. World Health Organ.

Drug resistance in malaria parasites of animals and man

Adv. Parasitol.

Sequence variation in the Plasmodium vivax dihydrofolate reductase-thymidylate synthase gene and their relationship with pyrimethamine resistance

Mol. Biochem. Parasitol.

Novel point mutations in the dihydrofolate reductase gene of Plasmodium vivax: evidence for sequential selection by drug pressure

Antimicrob. Agents Chemother.

Therapeutic responses to different antimalarial drugs in vivax malaria

Antimicrob. Agents Chemother.

Vivax series:
Plasmodium vivax transmission: chances for control?