Chemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria.
Effective use of anti-malarial drugs is key to reducing the transmission potential of Plasmodium vivax. In patients presenting with symptomatic disease, treatment with potent and relatively slowly eliminated blood schizontocidal regimens administered concurrently with a supervised course of 7 mg/kg...
| Main Authors: | , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2012
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| _version_ | 1826273387828215808 |
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| author | Douglas, N John, G von Seidlein, L Anstey, N Price, R |
| author_facet | Douglas, N John, G von Seidlein, L Anstey, N Price, R |
| author_sort | Douglas, N |
| collection | OXFORD |
| description | Effective use of anti-malarial drugs is key to reducing the transmission potential of Plasmodium vivax. In patients presenting with symptomatic disease, treatment with potent and relatively slowly eliminated blood schizontocidal regimens administered concurrently with a supervised course of 7 mg/kg primaquine over 7-14 days has potential to exert the greatest transmission-blocking benefit. Given the spread of chloroquine-resistant P. vivax strains, the artemisinin combination therapies dihydroartemisinin + piperaquine and artesunate + mefloquine are currently the most assured means of preventing P. vivax recrudescence. Preliminary evidence suggests that, like chloroquine, these combinations potentiate the hypnozoitocidal effect of primaquine, but further supportive evidence is required. In view of the high rate of P. vivax relapse following falciparum infections in co-endemic regions, there is a strong argument for broadening current radical cure policy to include the administration of hypnozoitocidal doses of primaquine to patients with Plasmodium falciparum malaria. The most important reservoir for P. vivax transmission is likely to be very low-density, asymptomatic infections, the majority of which will arise from liver-stage relapses. Therefore, judicious mass administration of hypnozoitocidal therapy will reduce transmission of P. vivax to a greater extent than strategies focused on treatment of symptomatic patients. An efficacious hypnozoitocidal agent with a short curative treatment course would be particularly useful in mass drug administration campaigns. |
| first_indexed | 2024-03-06T22:27:25Z |
| format | Journal article |
| id | oxford-uuid:57203cef-cf58-4926-ac8f-5a362f30087c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:27:25Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:57203cef-cf58-4926-ac8f-5a362f30087c2022-03-26T16:54:43ZChemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:57203cef-cf58-4926-ac8f-5a362f30087cEnglishSymplectic Elements at Oxford2012Douglas, NJohn, Gvon Seidlein, LAnstey, NPrice, REffective use of anti-malarial drugs is key to reducing the transmission potential of Plasmodium vivax. In patients presenting with symptomatic disease, treatment with potent and relatively slowly eliminated blood schizontocidal regimens administered concurrently with a supervised course of 7 mg/kg primaquine over 7-14 days has potential to exert the greatest transmission-blocking benefit. Given the spread of chloroquine-resistant P. vivax strains, the artemisinin combination therapies dihydroartemisinin + piperaquine and artesunate + mefloquine are currently the most assured means of preventing P. vivax recrudescence. Preliminary evidence suggests that, like chloroquine, these combinations potentiate the hypnozoitocidal effect of primaquine, but further supportive evidence is required. In view of the high rate of P. vivax relapse following falciparum infections in co-endemic regions, there is a strong argument for broadening current radical cure policy to include the administration of hypnozoitocidal doses of primaquine to patients with Plasmodium falciparum malaria. The most important reservoir for P. vivax transmission is likely to be very low-density, asymptomatic infections, the majority of which will arise from liver-stage relapses. Therefore, judicious mass administration of hypnozoitocidal therapy will reduce transmission of P. vivax to a greater extent than strategies focused on treatment of symptomatic patients. An efficacious hypnozoitocidal agent with a short curative treatment course would be particularly useful in mass drug administration campaigns. |
| spellingShingle | Douglas, N John, G von Seidlein, L Anstey, N Price, R Chemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria. |
| title | Chemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria. |
| title_full | Chemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria. |
| title_fullStr | Chemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria. |
| title_full_unstemmed | Chemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria. |
| title_short | Chemotherapeutic strategies for reducing transmission of Plasmodium vivax malaria. |
| title_sort | chemotherapeutic strategies for reducing transmission of plasmodium vivax malaria |
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