Transmission-blocking activities of artesunate, chloroquine, and methylene blue on Plasmodium vivax gametocytes
Issued Date
2024-09-04
Resource Type
eISSN
10986596
Scopus ID
2-s2.0-85203302560
Pubmed ID
39058023
Journal Title
Antimicrobial agents and chemotherapy
Volume
68
Issue
9
Rights Holder(s)
SCOPUS
Bibliographic Citation
Antimicrobial agents and chemotherapy Vol.68 No.9 (2024) , e0085324
Suggested Citation
Chaumeau V., Wasisakun P., Watson J.A., Oo T., Aryalamloed S., Sue M.P., Htoo G.N., Tha N.M., Archusuksan L., Sawasdichai S., Gornsawun G., Mehra S., White N.J., Nosten F.H. Transmission-blocking activities of artesunate, chloroquine, and methylene blue on Plasmodium vivax gametocytes. Antimicrobial agents and chemotherapy Vol.68 No.9 (2024) , e0085324. doi:10.1128/aac.00853-24 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/101197
Title
Transmission-blocking activities of artesunate, chloroquine, and methylene blue on Plasmodium vivax gametocytes
Corresponding Author(s)
Other Contributor(s)
Abstract
Plasmodium vivax is now the main cause of malaria outside Africa. The gametocytocidal effects of antimalarial drugs are important to reduce malaria transmissibility, particularly in low-transmission settings, but they are not well characterized for P. vivax. The transmission-blocking effects of chloroquine, artesunate, and methylene blue on P. vivax gametocytes were assessed. Blood specimens were collected from patients presenting with vivax malaria, incubated with or without the tested drugs, and then fed to mosquitos from a laboratory-adapted colony of Anopheles dirus (a major malaria vector in Southeast Asia). The effects on oocyst and sporozoite development were analyzed under a multi-level Bayesian model accounting for assay variability and the heterogeneity of mosquito Plasmodium infection. Artesunate and methylene blue, but not chloroquine, exhibited potent transmission-blocking effects. Gametocyte exposures to artesunate and methylene blue reduced the mean oocyst count 469-fold (95% CI: 345 to 650) and 1,438-fold (95% CI: 970 to 2,064), respectively. The corresponding estimates for the sporozoite stage were a 148-fold reduction (95% CI: 61 to 470) and a 536-fold reduction (95% CI: 246 to 1,311) in the mean counts, respectively. In contrast, high chloroquine exposures reduced the mean oocyst count only 1.40-fold (95% CI: 1.20 to 1.64) and the mean sporozoite count 1.34-fold (95% CI: 1.12 to 1.66). This suggests that patients with vivax malaria often remain infectious to anopheline mosquitos after treatment with chloroquine. Use of artemisinin combination therapies or immediate initiation of primaquine radical cure should reduce the transmissibility of P. vivax infections.