Population heterogeneity in Plasmodium vivax relapse risk
1
Issued Date
2022-12-01
Resource Type
ISSN
19352727
eISSN
19352735
Scopus ID
2-s2.0-85145491659
Pubmed ID
36534705
Journal Title
PLoS Neglected Tropical Diseases
Volume
16
Issue
12
Rights Holder(s)
SCOPUS
Bibliographic Citation
PLoS Neglected Tropical Diseases Vol.16 No.12 (2022)
Suggested Citation
Stadler E., Cromer D., Mehra S., Adekunle A.I., Flegg J.A., Anstey N.M., Watson J.A., Chu C.S., Mueller I., Robinson L.J., Schlub T.E., Davenport M.P., Khoury D.S. Population heterogeneity in Plasmodium vivax relapse risk. PLoS Neglected Tropical Diseases Vol.16 No.12 (2022). doi:10.1371/journal.pntd.0010990 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85180
Title
Population heterogeneity in Plasmodium vivax relapse risk
Author's Affiliation
Faculty of Tropical Medicine, Mahidol University
The University of Sydney School of Public Health
Papua New Guinea Institute of Medical Research
Walter and Eliza Hall Institute of Medical Research
The Kirby Institute
University of Melbourne
Menzies School of Health Research
James Cook University
Nuffield Department of Medicine
Burnet Institute
The University of Sydney School of Public Health
Papua New Guinea Institute of Medical Research
Walter and Eliza Hall Institute of Medical Research
The Kirby Institute
University of Melbourne
Menzies School of Health Research
James Cook University
Nuffield Department of Medicine
Burnet Institute
Other Contributor(s)
Abstract
A key characteristic of Plasmodium vivax parasites is their ability to adopt a latent liver-stage form called hypnozoites, able to cause relapse of infection months or years after a primary infection. Relapses of infection through hypnozoite activation are a major contributor to blood-stage infections in P vivax endemic regions and are thought to be influenced by factors such as febrile infections which may cause temporary changes in hypnozoite activation leading to ‘temporal heterogeneity’ in reactivation risk. In addition, immunity and variation in exposure to infection may be longer-term characteristics of individuals that lead to ‘popula-tion heterogeneity’ in hypnozoite activation. We analyze data on risk of P vivax in two previously published data sets from Papua New Guinea and the Thailand-Myanmar border region. Modeling different mechanisms of reactivation risk, we find strong evidence for population heterogeneity, with 30% of patients having almost 70% of all P vivax infections. Model fitting and data analysis indicates that individual variation in relapse risk is a primary source of heterogeneity of P vivax risk of recurrences. Trial Registration: ClinicalTrials.gov NCT01640574, NCT01074905, NCT02143934.