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Title: Gametocyte dynamics and the role of drugs in reducing the transmission potential of plasmodium vivax
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
Menzies School of Health Research
Nuffield Department of Clinical Medicine
University of Melbourne
Shoklo Malaria Research Unit
Badan Penelitian Dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia
Mimika District Health Authority
National Institutes of Health, Bethesda
Mahidol University
Royal Darwin Hospital
Keywords: Medicine
Issue Date: 1-Sep-2013
Citation: Journal of Infectious Diseases. Vol.208, No.5 (2013), 801-812
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. © 2013 The Author.
ISSN: 00221899
Appears in Collections:Scopus 2011-2015

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