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Resolving the cause of recurrent Plasmodium vivax malaria probabilistically

Author

Listed:
  • Aimee R. Taylor

    (Harvard T. H. Chan School of Public Health
    Broad Institute of MIT and Harvard)

  • James A. Watson

    (Mahidol University
    University of Oxford)

  • Cindy S. Chu

    (University of Oxford
    Shoklo Malaria Research Unit)

  • Kanokpich Puaprasert

    (Mahidol University)

  • Jureeporn Duanguppama

    (Mahidol University)

  • Nicholas P. J. Day

    (Mahidol University
    University of Oxford)

  • Francois Nosten

    (University of Oxford
    Shoklo Malaria Research Unit)

  • Daniel E. Neafsey

    (Broad Institute of MIT and Harvard
    Harvard T. H. Chan School of Public Health)

  • Caroline O. Buckee

    (Harvard T. H. Chan School of Public Health)

  • Mallika Imwong

    (Mahidol University
    Mahidol University)

  • Nicholas J. White

    (Mahidol University
    University of Oxford)

Abstract

Relapses arising from dormant liver-stage Plasmodium vivax parasites (hypnozoites) are a major cause of vivax malaria. However, in endemic areas, a recurrent blood-stage infection following treatment can be hypnozoite-derived (relapse), a blood-stage treatment failure (recrudescence), or a newly acquired infection (reinfection). Each of these requires a different prevention strategy, but it was not previously possible to distinguish between them reliably. We show that individual vivax malaria recurrences can be characterised probabilistically by combined modelling of time-to-event and genetic data within a framework incorporating identity-by-descent. Analysis of pooled patient data on 1441 recurrent P. vivax infections in 1299 patients on the Thailand–Myanmar border observed over 1000 patient follow-up years shows that, without primaquine radical curative treatment, 3 in 4 patients relapse. In contrast, after supervised high-dose primaquine only 1 in 40 relapse. In this region of frequent relapsing P. vivax, failure rates after supervised high-dose primaquine are significantly lower (∼3%) than estimated previously.

Suggested Citation

  • Aimee R. Taylor & James A. Watson & Cindy S. Chu & Kanokpich Puaprasert & Jureeporn Duanguppama & Nicholas P. J. Day & Francois Nosten & Daniel E. Neafsey & Caroline O. Buckee & Mallika Imwong & Nicho, 2019. "Resolving the cause of recurrent Plasmodium vivax malaria probabilistically," Nature Communications, Nature, vol. 10(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:10:y:2019:i:1:d:10.1038_s41467-019-13412-x
    DOI: 10.1038/s41467-019-13412-x
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    Cited by:

    1. Sasha V. Siegel & Hidayat Trimarsanto & Roberto Amato & Kathryn Murie & Aimee R. Taylor & Edwin Sutanto & Mariana Kleinecke & Georgia Whitton & James A. Watson & Mallika Imwong & Ashenafi Assefa & Awa, 2024. "Lineage-informative microhaplotypes for recurrence classification and spatio-temporal surveillance of Plasmodium vivax malaria parasites," Nature Communications, Nature, vol. 15(1), pages 1-16, December.

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