Plasmodium vivax merozoite surface protein-1 paralog (PvMSP1P) is a glycosylphosphatidylinositol-anchored protein expressed on the merozoite surface. This molecule is a target of natural immunity, as high anti-MSP1P-19 antibody levels were detected during P. vivax infection and the antibody inhibited PvMSP1P-erythrocyte binding. Recombinant PvMSP1P antigen results in production of a significant Th1 cytokine response in immunized mice. The present study was performed to characterize natural cellular immunity against PvMSP1P-19 and PvDBP region II in acute and recovery P. vivax infection. Peripheral blood mononuclear cells (PBMCs) from acute and recovery P. vivax infection were obtained for lymphocyte proliferation assay upon PvMSP1P-19 and PvDBP region II antigen stimulation. The culture supernatant was examined for the presence of the cytokines IL-2, TNF, IFN-γ and IL-10 by enzyme-linked immunosorbent assay (ELISA). To determine whether Th1 or Th2 have a memory response against PvMSP1P-19 and PvDBPII

The aim of this study was to develop a simple, field-practical, and effective in vitro method for determining the sensitivity of fresh erythrocytic Plasmodium vivax isolates to a range of antimalarials. The method used is a modification of the standard World Health Organization (WHO) microtest for determination of P. falciparum drug sensitivity. The WHO method was modified by removing leukocytes and using a growth medium supplemented with AB(+) serum. We successfully carried out 34 in vitro drug assays on 39 P. vivax isolates collected from the Mae Sod malaria clinic, Tak Province, Thailand. The mean percentage of parasites maturing to schizonts (six or more merozoites) in control wells was 66.5% +/- 5.9% (standard deviation). This level of growth in the control wells enabled rapid microscopic determination (5 min per isolate per drug) of the MICs of chloroquine, dihydroartemisinin, WR238605 (tafenoquine), and sulfadoxine. P. vivax was relatively sensitive to chloroquine (MIC = 160 ng/ml, 50% inhibitory

Plasmodium vivax threatens nearly half the worlds population and is a significant impediment to achievement of the millennium development goals. It is an important, but incompletely understood, cause of anaemia. This review synthesizes current evidence on the epidemiology, pathogenesis, treatment and consequences of vivax-associated anaemia. Young children are at high risk of clinically significant and potentially severe vivax-associated anaemia, particularly in countries where transmission is intense and relapses are frequent. Despite reaching lower densities than Plasmodium falciparum, Plasmodium vivax causes similar absolute reduction in red blood cell mass because it results in proportionately greater removal of uninfected red blood cells. Severe vivax anaemia is associated with substantial indirect mortality and morbidity through impaired resilience to co-morbidities, obstetric complications and requirement for blood transfusion. Anaemia can be averted by early and effective anti-malarial ...

Annually, an estimated 219 million people are infected with malaria and the disease is endemic in 104 countries[1]. Plasmodium falciparum malaria is associated with the highest mortality and is accordingly prioritized in research and control. Another species, Plasmodium vivax, has gained less scientific attention despite being the most widely distributed malaria species endemic in tropical and subtropical countries worldwide, with an estimated 2.8 billion people currently at risk[2-4]. It is estimated that at least 130 million people are infected with P. vivax annually[5], causing significant economic and financial burden to affected countries[6].. In historic Europe, P. vivax malaria was endemic in many countries, reaching as far as Finland and England in the north[6, 7]. Malaria disappeared from Europe in the mid-20th Century, likely as a result of a combination of various factors, including improved housing conditions, better health care services, and the implementation of various malaria ...

The incidence of Plasmodium vivax infection has declined markedly in Malaysia over the past decade despite evidence of high-grade chloroquine resistance. Here we investigate the genetic changes in a P. vivax population approaching elimination in 51 isolates from Sabah, Malaysia and compare these with data from 104 isolates from Thailand and 104 isolates from Indonesia. Sabah displays extensive population structure, mirroring that previously seen with the emergence of artemisinin-resistant P. falciparum founder populations in Cambodia. Fifty-four percent of the Sabah isolates have identical genomes, consistent with a rapid clonal expansion. Across Sabah, there is a high prevalence of loci known to be associated with antimalarial drug resistance. Measures of differentiation between the three countries reveal several gene regions under putative selection in Sabah. Our findings highlight important factors pertinent to parasite resurgence and molecular cues that can be used to monitor low-endemic ...

The Duffy-binding protein II of Plasmodium vivax (PvDBPII) has been considered as an attractive target for vaccine-mediated immunity despite a possible highly polymorphic nature. Among seven PvDBP domains, domain II has been shown to exhibit a high rate of nonsynonymous polymorphism, which has been suggested to be a potential immune (antibody binding) evasion mechanism. This study aimed to determine the extent of genetic polymorphisms and positive natural selection at domain II of the PvDBP gene among a sampling of Thai P. vivax isolates. The PvDBPII gene was PCR amplified and the patterns of polymorphisms were characterized from 30 Thai P. vivax isolates using DNA cloning and sequencing. Phylogenetic analysis of the sequences and positive selection were done using DnaSP ver 4.0 and MEGA ver 4.0 packages. This study demonstrated a high rate of nonsynonymous polymorphism. Using Sal I as the reference strain, a total of 30 point-mutations were observed in the PvDBPII gene among the set of Thai P. vivax

Plasmodium vivax apical membrane antigen-1(PvAMA-1) is a surface protein with polymorphic sites. This study was aimed to analyze the polymorphic amino acid residues at PvAMA-1 in different infected age groups. 92 blood samples were collected from south and southeast of Iran. The DNA coding for the domain I (DI), DII, and partial ...

Plasmodium vivax is a protozoal parasite and a human pathogen. This parasite is the most frequent and widely distributed cause of recurring malaria, P. vivax is one of the five species of malaria parasites that commonly infect humans.[2] Although it is less virulent than Plasmodium falciparum, the deadliest of the five human malaria parasites, P. vivax malaria infections can lead to severe disease and death, often due to splenomegaly .[3][4] P. vivax is carried by the female Anopheles mosquito, since it is only the female of the species that bites.[5]

BACKGROUND: Plasmodium vivax malaria is a major public health challenge in Latin America, Asia and Oceania, with 130-435 million clinical cases per year worldwide. Invasion of host blood cells by P. vivax mainly depends on a type I membrane protein called Duffy binding protein (PvDBP). The erythrocyte-binding motif of PvDBP is a 170 amino-acid stretch located in its cysteine-rich region II (PvDBPII), which is the most variable segment of the protein. METHODS: To test whether diversifying natural selection has shaped the nucleotide diversity of PvDBPII in Brazilian populations, this region was sequenced in 122 isolates from six different geographic areas. A Bayesian method was applied to test for the action of natural selection under a population genetic model that incorporates recombination. The analysis was integrated with a structural model of PvDBPII, and T- and B-cell epitopes were localized on the 3-D structure. RESULTS: The results suggest that: (i) recombination plays an important role in

TY - JOUR. T1 - Genomics, Population Genetics and Evolutionary History of Plasmodium vivax. AU - Carlton, Jane M.. AU - Das, Aparup. AU - Escalante, Ananias A.. PY - 2013. Y1 - 2013. N2 - Plasmodium vivax is part of a highly diverse clade that includes several Plasmodium species found in nonhuman primates from Southeast Asia. The diversity of primate malarias in Asia is staggering; nevertheless, their origin was relatively recent in the evolution of Plasmodium. We discuss how humans acquired the lineage leading to P. vivax from a nonhuman primate determined by the complex geological processes that took place in Southeast Asia during the last few million years. We conclude that widespread population genomic investigations are needed in order to understand the demographic processes involved in the expansion of P. vivax in the human populations. India represents one of the few countries with widespread vivax malaria. Earlier studies have indicated high genetic polymorphism at antigenic loci and no ...

Background: Evidence for decreasing chloroquine (CQ) efficacy against Plasmodium vivax has been reported from many endemic countries in the world. In Ethiopia, P. vivax accounts for 40% of all malaria cases and CQ is the first-line drug for vivax malaria. Mutations in multidrug resistance 1 (pvmdr-1) and K10 insertion in the pvcrt-o genes have been identified as possible molecular markers of CQ-resistance (CQR) in P. vivax. Despite reports of CQ treatment failures, no data are currently available on the prevalence of molecular markers of P. vivax resistance in Ethiopia. The objective of this study was to determine the prevalence of mutations in the pvmdr-1 and K10 insertion in the pvcrt-o genes. Methods: A total of 36 P. vivax clinical isolates were collected from West Arsi district in Ethiopia. Sequencing was used to analyse polymorphisms of the pvcrt-o and pvmdr-1 genes. Results: Sequencing results of the pvmdr-1 fragment showed the presence of two non-synonymous mutations at positions 976 and ...

OBJECTIVES: Methylene blue, once discarded due to its unsettling yet mild side effects, has now found a renewed place in the pharmacopoeia of modern medicine. The continued spread of drug-resistant Plasmodium vivax and Plasmodium falciparum has also led to a recent re-examination of methylene blues potent antimalarial properties. Here we examine the ex vivo susceptibility profile of Plasmodium spp. isolates to methylene blue; the isolates were from a region on the Thai-Myanmar border where there are increasing rates of failure when treating vivax malaria with chloroquine. METHODS: To do this we used a newly developed ex vivo susceptibility assay utilizing flow cytometry and a portable flow cytometer with a near-UV laser. RESULTS: P. vivax (median methylene blue IC50 3.1 nM, IQR 1.7-4.3 nM) and P. falciparum (median methylene blue IC50 1.8 nM, IQR 1.6-2.3 nM) are susceptible to methylene blue treatment at physiologically relevant levels. Unfortunately, the addition of chloroquine to combination

BACKGROUND: Infection by Plasmodium vivax has been considered rarely threatening to life, but recent studies challenge this notion. This study documented the frequency and character of severe illness in paediatric patients admitted to a hospital in south-eastern Pakistan with a laboratory-confirmed diagnosis of vivax malaria. METHODS: An observational study of all 180 paediatric patients admitted with any diagnosis of malaria during 2010 was conducted: 128 P. vivax; 48 Plasmodium falciparum; and four mixed infections of these species. Patients were classified as having severe illness with any of the following indicators: Glascow coma scale |11; ≥2 convulsions; haemoglobin |5g/dL; thrombocytes |50,000/mL; blood glucose |45mg%; |70 breaths/min; or intravenous anti-malarial therapy. Additionally, 64 patients with a diagnosis of vivax malaria were treated during 2009, and the 21 of these having severe illness were included in analyses of the frequency and character of severe illness with that diagnosis.

Participants at this 6th international conference dedicated to Plasmodium vivax malaria research are being treated to the stunning surrounds of the Rio Negro, just upstream of the confluence with the Rio Solimões and the birth of the awesome Amazon river. This exceptional location is no doubt contributing to the buzzing atmosphere as a record 405 colleagues reunite for this conference, enabled in part by an impressive 41 travel awards for students and early-career scientists from across the world.. A busy day of diverse pre-meeting courses overseen by Stefanie Lopes and Carmen Fernandez-Becerra has whet the appetite for the main meeting. Dynamic session organisers (see Programme) triggered lively discussions reminding participants of the key and unique features of P. vivax malaria, and of the challenges and dilemmas confronting the P. vivax community and country programmes in particular.. A morning session led by Rogério Amino, Mary Galinski and Letusa Albrecht covered updates in parasite ...

Background Plasmodium vivax continues to be the most widely distributed malarial parasite species in tropical and sub-tropical areas, causing high morbidity indices around the world. Better understanding of the proteins used by the parasite during the invasion of red blood cells is required to obtain an effective vaccine against this disease. This study describes characterizing the P. vivax asparagine-rich protein (PvARP) and examines its antigenicity in natural infection. Methods The target gene in the study was selected according to a previous in silico analysis using profile hidden Markov models which identified P. vivax proteins that play a possible role in invasion. Transcription of the arp gene in the P. vivax VCG-1 strain was here evaluated by RT-PCR. Specific human antibodies against PvARP were used to confirm protein expression by Western blot as well as its subcellular localization by immunofluorescence. Recognition of recombinant PvARP by sera from P. vivax-infected individuals was ...

We examined geographically distinct isolates of Plasmodium vivax and categorized them according to developmental success in Anopheles albimanus. We found that parasites from Central America and Colombia form a group distinct from those of Asia. New World isolates have a distinct chromosomal translocation and an episomal variation in the open reading frame (ORF) 470 DNA sequence that distinguishes them from the other isolates tested. Old World types of P. vivax were introduced into the Americas, and a remnant of this lineage remains in P. simium. It is indistinguishable from Old World P. vivax to the extent determinable by using our encoded markers and the examination of its developmental pattern in mosquitoes. The cohesive characteristics that separate types of P. vivax are predictors of range and potential for transmission and hence require taxonomic distinction ...

Although Plasmodium vivax is a leading cause of malaria around the world, only a handful of vivax antigens are being studied for vaccine development. Here, we investigated genetic signatures of selection and geospatial genetic diversity of two leading vivax vaccine antigens--Plasmodium vivax merozoite surface protein 1 (pvmsp-1) and Plasmodium vivax circumsporozoite protein (pvcsp). Using scalable next-generation sequencing, we deep-sequenced amplicons of the 42 kDa region of pvmsp-1 (n = 44) and the complete gene of pvcsp (n = 47) from Cambodian isolates. These sequences were then compared with global parasite populations obtained from GenBank. Using a combination of statistical and phylogenetic methods to assess for selection and population structure, we found strong evidence of balancing selection in the 42 kDa region of pvmsp-1, which varied significantly over the length of the gene, consistent with immune-mediated selection. In pvcsp, the highly variable central repeat region also showed patterns

Author summary Plasmodium vivax transmission is heterogeneous and discontinuous in the Peruvian Amazon. Such heterogeneity is the result of factors that include, but are not restricted to, the environment, public policies, and characteristics of the parasite, the vector, and human activities. All these factors make P. vivax transmission resilient to interventions. In order to achieve the goals of control and local elimination, P. vivax surveillance must inform how those factors sustain disease transmission in order to focalize and synchronize control strategies. In this study, we implemented molecular surveillance complemented with population genetic tools in the areas of Cahuide, Lupuna, and Santa Emilia located in the Peruvian Amazon. In particular, we characterize the transmission and the parasite genetic variation in these sites from September 2012 to March 2015. The changes in parasite diversity, the wide geographic dispersion of parasite subpopulation and the introduction of a new parasite clone

Abstract The population dynamics of two Plasmodium vivax polymorphs were studied over a two-year period in a village in a hyperendemic area of Papua New Guinea in both the mosquito and human populations. Strains of P. vivax were distinguished by different circumsporozoite (CS) protein repeats, the VK210 (classic) and the VK247 (variant) polymorphs. In 1986, 34% of P. vivax CS protein-positive mosquitoes were of the VK247 type. Although the proportion of P. vivax sporozoite antigen-positive mosquitoes compared with all sporozoite-positive mosquitoes did not change from 1986 to 1987, the proportion of P. vivax-positive mosquitoes of the VK247 polymorph decreased significantly from 34% to 11% (5 of 45) in 1987. In 1986, 61% (47 of 77) of humans tested had IgGs that recognized the VK247 CS repeat, while only 26% (22 of 84) had IgGs that recognized the VK210 CS repeat. The observed fluctuation in the proportion of the two P. vivax CS protein polymorphs recorded in the mosquito population from 1986 to 1987 is

Authors: Babon, Jeffrey; Morgan, William; Geoff, Kelly; John, Eccleston; James, Feeney; Anthony, Holder. Citation: Babon, Jeffrey; Morgan, William; Kelly, Geoff; Eccleston, John; Feeney, James; Holder, Anthony. Structural studies on Plasmodium vivax merozoite surface protein-1. Mol. Biochem. Parasitol. 153, 31-40 (2007).. Assembly members: ...

BACKGROUND: Despite that over 90 million pregnancies are at risk of Plasmodium vivax infection annually, little is known about the epidemiology and impact of the infection in pregnancy. METHODOLOGY AND PRINCIPAL FINDINGS: We undertook a health facility-based prospective observational study in pregnant women from Guatemala (GT), Colombia (CO), Brazil (BR), India (IN) and Papua New Guinea PNG). Malaria and anemia were determined during pregnancy and fetal outcomes assessed at delivery. A total of 9388 women were enrolled at antennal care (ANC), of whom 53% (4957) were followed until delivery. Prevalence of P. vivax monoinfection in maternal blood at delivery was 0.4% (20/4461) by microscopy [GT 0.1%, CO 0.5%, BR 0.1%, IN 0.2%, PNG 1.2%] and 7% (104/1488) by PCR. P. falciparum monoinfection was found in 0.5% (22/4463) of women by microscopy [GT 0%, CO 0.5%, BR 0%, IN 0%, PNG 2%]. P. vivax infection was observed in 0.4% (14/3725) of placentas examined by microscopy and in 3.7% (19/508) by PCR. P. ...

Project details Renewed intensification of global malaria control efforts over the past 10 years has had significant success, however, key challenges remain, including the predominance of the species Plasmodium vivax in regions nearing elimination. Development of an effective vaccine against P. vivax would make elimination a more attainable goal.

The P. vivax parasite exhibits higher genetic diversity than P. falciparum, especially for the gene families associated with merozoite invasion or immune response modulation (e.g., the msp3, vir, and msp7 gene families) [20-22]. The high genetic diversity and natural selection of P. vivax vaccine targets is common existed in isolates world-wide [23,24]. The PvMSP1 locus codes for a major asexual blood-stage antigen currently proposed as a malaria vaccine candidate antigen. Reports of extensive polymorphism of this protein from field isolates and clones from different geographical areas remain a major challenge. Numerous studies on the genetic diversity of PvMSP1 in P. vivax field isolates have been carried out in many different geographic areas [25,26]. However, there is no available data for PvMSP142 from southern border areas adjacent to Myanmar and the inland cases in China.. In this study, we present several sets of genetic information for PvMSP142 of populations from inland China and CMB ...

Problem/Condition: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occu ...

Abstract With strict adherence to ethical guidelines, a volunteer was immunized against sporozoites of Plasmodium falciparum and P. vivax, the antigen consisting of attenuated sporozoites of each species inoculated through bites of mosquitoes X-irradiated at a minimum dosage of 15,000 rads. On one occasion this dosage did not render all P. vivax sporozoites noninfective. Species specificity of antigen and antibody was demonstrated, but within each species a wide geographical diversity of strains proved interchangeably antigenic and susceptible to the antibody. Once immunized, the volunteer was protected for not more than 3 months and 6 months, respectively, from infective P. falciparum and P. vivax sporozoites, the duration of protection being reflected by a positive species-specific circumsporozoite reaction. Studies in this volunteer, and in two others immunized with P. falciparum sporozoites, did not reveal any increase in serum levels of immunoglobulins G and M.

|jats:p|Vivax malaria relapses frequently even in low-transmission settings. Chloroquine delays but does not prevent recurrences. Adding primaquine to a slowly eliminated schizonticide significantly reduces recurrences and improves hematocrit, but this advantage is offset by hemolysis in G6PD-deficient females.|/jats:p|

Recurrence rates of Plasmodium vivax infections differ across various geographic regions. Interestingly, South-East Asia and the Asia-Pacific region are documented to exhibit the most frequent recurrence incidences. Identifying patients at a higher risk for recurrences gives valuable information in strengthening the efforts to control P. vivax infections. The aim of the study was to develop a tool to identify P. vivax- infected patients that are at a higher risk of recurrence in Malaysia. Patient data was obtained retrospectively through the Ministry of Health, Malaysia, from 2011 to 2016. Patients with incomplete data were excluded. A total of 2044 clinical P. vivax malaria cases treated with primaquine were included. Data collected were patient, disease, and treatment characteristics. Two-thirds of the cases (n = 1362) were used to develop a clinical risk score, while the remaining third (n = 682) was used for validation. Using multivariate analysis, age (p = 0.03), gametocyte sexual count (p = 0.04),

Author Summary Most of the 250 million malaria cases outside of Africa are caused by the parasite Plasmodium vivax. Although drugs can be used to treat P. vivax malaria, drug resistance is spreading and there is no available vaccine. Because this species cannot be readily grown in the laboratory there are added challenges to understanding the function of the many hypothetical genes in the genome. We isolated transcriptional messages from parasites growing in human blood and in mosquitoes, labeled the messages and measured how their levels for different parasite growth conditions. The data for 5,419 parasite genes shows extensive changes as the parasite moves between human and mosquito and reveals highly expressed genes whose proteins might represent new therapeutic targets for experimental vaccines. We discover sets of genes that are likely to play a role in the earliest stages of hepatocyte infection. We find intriguing differences in the expression patterns of different blood stage parasites that may

Association between malaria and risk factors. Frequencies for risk factors among cases and controls and associated bivariate and multivariate odds ratios are presented in table III. Eighteen variables out of 99 were significantly associated (p , 0.05) with increased risk of malaria. Correlation coefficient values were less than 0.8 in all cases, indicating no colinearity. The percentages of cases and controls that referred to a place of birth other than the locality where they were living were 23.5 and 13.45%, respectively, and this condition was associated with a three-fold (OR 3.16, 95% CI 1.16-6.13) greater risk of malaria infection.. The risk of malaria infection increased in subjects who spoke only an autochthonous language (13.4%, OR 2.48, 95% CI 1.19-3.77) compared to subjects who spoke Spanish and both Spanish and an autochthonous language (4.2%).. The proportions of cases in the medium and low MKI levels were 48.7% and 31.0%, respectively, compared to 48.3 and 24.4 % of controls, ...

GSK and Medicines for Malaria Venture announced FDA approval of single-dose tafenoquine for the radical cure (prevention of relapse) of Plasmodium vivax malaria in patients aged 16 years and older who are receiving appropriate antimalarial therapy for acute P. vivax infection.. Tafenoquine is an 8-aminoquinoline derivative with activity against all stages of the P. vivax life cycle, including hypnozoites. It was first synthesised by scientists at the Walter Reed Army Institute of Research in 1978. Approval was based on efficacy and safety data from a comprehensive global clinical development P. vivax radical cure program designed in agreement with FDA. Thirteen studies in healthy volunteers and patients directly supported the program.. The primary evidence for clinical efficacy and safety of the 300-mg single dose was provided by three randomized, double-blind studies: DETECTIVE Part 1 and Part 2 (TAF112582) and GATHER (TAF116564) involving 800 participants. Results of the two Phase III studies ...

Analysis of lymphocytes in patients with Plasmodium vivax malaria and its relation to the annexin-A1 and IL-10: BackgroundMalaria is the most prevalent parasiti

The malaria burden in Viet Nam has been in decline in recent decades, but localised areas of high transmission remain. We used spatiotemporal analytical tools to determine the social and environmental drivers of malaria risk and to identify residual high-risk areas where control and surveillance resources can be targeted. Counts of reported Plasmodium falciparum and Plasmodium vivax malaria cases by month (January 2007-December 2008) and by district were assembled. Zero-inflated Poisson regression models were developed in a Bayesian framework. Models had the percentage of the districts population living below the poverty line, percent of the district covered by forest, median elevation, median long-term average precipitation, and minimum temperature included as fixed effects, and terms for temporal trend and residual district-level spatial autocorrelation. Strong temporal and spatial heterogeneity in counts of malaria cases was apparent. Poverty and forest cover were significantly associated with an

|strong|Human anti plasmodium vivax LDH, clone AbD13978|/strong| recognizes LDH (L-lactose dehydrogenase) from the Malaria causing protozoan species |i|Plasmodium vivax|/i|. It was shown to cross-reac…

In 2002, the vivax malaria community has created a forum for providing a friendly environment to share and discuss research results on Plasmodium vivax. Meetings were held in Bangkok, Rockville, Panama, Barcelona, Bali, and, this year, in Manaus.. The aim of this Thematic series Time to go for vivax (the motto of the Manaus meeting) is to emphasize this biennial event and the role it plays in the promotion of work on Plasmodium vivax. The articles in the series are all based on presentations given in Manaus.. Guest editors: Marcus V Lacerda and Hernando A del Portillo.. ...

Background: Cytokine-mediated endothelial activation pathway is a known mechanism of pathogenesis employed by Plasmodium falciparum to induce severe disease symptoms in human host. Though considered benign, complicated cases of Plasmodium vivax are being reported worldwide and from Pakistan. It has been hypothesized that P.vivax utilizes similar mechanism of pathogenesis, as that of P.falciparum for manifestations of severe malaria. Therefore, the main objective of this study was to characterize the role of cytokines and endothelial activation markers in complicated Plasmodium vivax isolates from Pakistan. Methods and Principle Findings: A case control study using plasma samples from well-characterized groups suffering from P.vivax infection including uncomplicated cases (n=100), complicated cases (n=82) and healthy controls (n=100) were investigated. Base line levels of Tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6), Interleukin-10 (IL-10), Intercellular adhesion molecule-1 (ICAM-1), Vascular

Travelers to many parts of the world are at risk for contracting malaria, According to the Centers for Disease Control and Prevention (CDC), approximately 1,700 cases occur each year among international travelers from the United States.. The US Food and Drug Administration (FDA) has recently approved the drug tafenoquine for two indications: Prophylaxis of malaria ( It can be used as prophylaxis in patients ≥18 years of age against all Plasmodium spp. and in any malarious area) and radical cure of Plasmodium vivax malaria.. Choosing a Drug to Prevent Malaria. The long half-life of tafenoquine (approximately 16 days) offers potential advantages in less frequent dosing for prophylaxis and a single-dose course for treatment.. ...

The research, carried out on the border of Thailand and Myanmar, highlights the importance of preventing malaria in pregnancy.. According to the World Malaria Report 2011, malaria killed an estimated 655 000 people in 2010. It is caused by parasites such as Plasmodium falciparum and Plasmodium vivax, which are injected into the bloodstream by infected mosquitoes.. Malaria is one of the most common parasitic infections to affect pregnancy. Previous studies have suggested that infection with both P. falciparum and P. vivax malaria during pregnancy reduces birth weight whether maternal symptoms are present or not; however, these studies have been hampered by difficulties in estimating gestational age accurately and diagnosing malaria infection in early pregnancy.. Now, in a study published in the open access journal PLoS One, researchers at the Shoklo Malaria Research Unit on the border of Thailand and Myanmar, part of the Wellcome Trust-Mahidol University-Oxford University Tropical Medicine ...

P. vivax along with other parasites within the Plasmodium genus rely on both an insect and vertebrate host to act as vectors for their infection. Additionally P. vivax uses the proteins within the blood of humans to reproduce and produce their own proteins. Once within the blood new mosquitoes that have not been infected and are hosts to the parasite can feed on the vertebrate host and themselves become an insect host to P vivax and further spread the infection to other vertebrae. This leads to the easy passive dispersal of the parasite. This parasitic nature leaves the host in potentially life-threatening danger, for up to years at a time. ...

The complex imprinted GNAS locus which encodes G-alpha subunit (G�s) is involved in a number of Gprotein coupled signaling pathways in eukaryotic cells. Erythrocyte invasion by Plasmodium falciparum parasites is significantly regulated by protein of GNAS gene. This study was designed to evaluate the association between single nucleotide polymorphisms (SNPs) present in GNAS locus and susceptibility to malaria. In this case control study, individuals affected by P. falciparum malaria (n = 230), Plasmodium vivax malaria (n = 230) and normal controls (n = 230) were tested for the association of eighteen (18) known SNPs to evaluate their role in the onset of the disease. There was no significant difference in genotype frequencies of all the SNPs tested between P. falciparum and P. vivax affected individuals. However, when Bonferroni correction for multiple comparisons were performed as a control, our results demonstrated alleles and genotypes of rs7121: C , T (NC 000020.10:g.57478807C , T), a ...

A large clinical trial led by Dr. Ivo Mueller, researcher at ISGlobal and the Walter and Eliza Hall Institute, Australia, shows that a great majority of P. vivax infections among children in Papua New Guinea are caused by the reactivation of hypnozoites, a dormant liver-stage of the parasite, and that these relapses contribute importantly to sustaining disease transmission. Further results of the study, published in Plos Medicine, indicate that massive drug administration campaigns combining blood- and liver- stage treatments are highly efficient for reducing P. vivax transmission and thereby provide important evidence-based recommendations for policy makers.. Over the last 20 years, there has been a significant reduction in overall malaria incidence. In parallel, outside Africa there has been a shift in Plasmodium species, with P. vivax now accounting for more than 90% of clinical cases in the vast majority of countries. P. vivax has the ability to relapse weeks, months or years after primary ...

The study is a proof-of-concept clinical investigation designed to develop a safe and practical sporozoite challenge model for Plasmodium vivax in humans with a goal of 100% infectivity rate. The development and standardization of such a model will make possible efficacy evaluations of candidate P. vivax vaccines in Phase 2a trials. This trial is conducted in collaboration with Armed Forces Research Institute of Medical Sciences (AFRIMS) investigators in Bangkok, Thailand, who will be recruiting adult blood donors from a pool of patients who present with active P. vivax infections in Thailand. Samples of P. vivax infected blood will be collected and fed via membrane feeding apparatus to colony-reared Anopheles dirus mosquitoes at the AFRIMS Entomology Lab. A portion of the same blood will meanwhile be screened for potential co-infections at the AFRIMS Retrovirology Laboratory. When screening tests have confirmed the presence of only P. vivax in the blood (no co-infections with other malaria ...

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Abstract: BACKGROUND: Malaria is of immense importance amongst the tropical diseases in India. There is a need to develop newer diagnostic aids and research is necessary to identify new prognostic markers for prediction of the course and complications. AIMS: To evaluate the white cell differential count and morphology in Plasmodium vivax and Plasmodium falciparum malaria and study their prognostic utility. SUBJECTS AND METHODS: Two hundred and sixty-four adult patients in the age range of 20 to 65 years presenting to the hospital over a period of 4 months with clinical features of malaria and a positive peripheral smear examination were studied. RESULTS: No statistically significant difference was noted in the white blood cell (WBC) count and neutrophil count in P.vivax versus P. falciparum malaria. Band cells were more frequently noted in P. falciparum malaria than in P.vivax malaria (p < 0.0001). Toxic granulation of the neutrophils was noted in 9.5% of the patients and exclusively in P. ...

RNP, LvS, JKB, NJW, JAS and NPD designed the study and all authors assisted in revision of the final protocol ethical submissions, YL designed the economic component of the study and AD assisted. TA, BA, AA, AGR, BB, SG, TTH, DJ, MK, AK, TL, IM, ZM, APP, NHP, HS, IS, YT, NVT, AW, RZ provide the logistics of setting up the study sites. PYC, MD, AMD, NHK, BL, PY and KT provide clinical trial support. KT and RNP wrote the first draft of the manuscript and all authors reviewed and contributed to the manuscript. The members of the IMPROV study group are (in alphabetical order): Tesfay Abreha, ICAP at Columbia Universitys Mailman School of Public Health, Addis Ababa, Ethiopia ([email protected]); Bereket Alemayehu, ICAP at Columbia Universitys Mailman School of Public Health, New York, USA ([email protected]); Ashenafi Assefa, Ethiopian Public Health Institute, Addis Ababa, Ethiopia ([email protected]); Ghulam Rahim Awab, Nangarhar Medical Faculty of Nangarhar University, Afghanistan ...

A new blood-stage parasite question has arisen. Are erythrocytic forms in bone marrow/spleen part of the hidden Plasmodium vivax reservoir? Do they cause or contribute to renewed or increased peripheral parasitaemia? (Link to the article on the subject [click here]).. ...

The association between SAO and P. vivax infection was examined through genotyping of 1,975 children enrolled in three independent epidemiological studies conducted in the Madang area of Papua New Guinea. SAO was associated with a statistically significant 46% reduction in the incidence of clinical P. vivax episodes (adjusted incidence rate ratio [IRR] = 0.54, 95% CI 0.40-0.72, p,0.0001) in a cohort of infants aged 3-21 months and a significant 52% reduction in P. vivax (blood-stage) reinfection diagnosed by PCR (95% CI 22-71, p = 0.003) and 55% by light microscopy (95% CI 13-77, p = 0.014), respectively, in a cohort of children aged 5-14 years. SAO was also associated with a reduction in risk of P. vivax parasitaemia in children 3-21 months (1,111/µl versus 636/µl, p = 0.011) and prevalence of P. vivax infections in children 15-21 months (odds ratio [OR] = 0.39, 95% CI 0.23-0.67, p = 0.001). In a case-control study of children aged 0.5-10 years, no child with SAO was found among 27 cases with ...

Microsatellite markers derived from simple sequence repeats have been useful in studying a number of human pathogens, including the human malaria parasite Plasmodium falciparum. Genetic markers for P. vivax would likewise help elucidate the genetics and population characteristics of this other important human malaria parasite. We have identified a locus in a P. vivax telomeric clone that contains simple sequence repeats. Primers were designed to amplify this region using a two-step semi-nested polymerase chain reaction protocol. The primers did not amplify template obtained from non-infected individuals, nor DNA from primates infected with the other human malaria parasites (P. ovale, P. malariae, or P. falciparum). The marker was polymorphic in P. vivax-infected field isolates obtained from Papua New Guinea, Indonesia and Guyana. This microsatellite marker may be useful in genetic and epidemiologic studies of P. vivax malaria.

Differences between Plasmodium vivax and Plasmodium falciparum. Plasmodium vivax and Plasmodium falciparum Differences. Plasmodium vivax vs falciparum.

Background The burden of malaria in Vietnam has drastically reduced, prompting the National Malaria Control Program to officially engage in elimination efforts. Plasmodium vivax is becoming increasingly prevalent, remaining a major problem in the countrys central and southern provinces. A better understanding of P. vivax genetic diversity and structure of local parasite populations will provide baseline data for the evaluation and improvement of current efforts for control and elimination. The aim of this study was to examine the population genetics and structure of P. vivax isolates from four communities in Tra Leng commune, Nam Tra My district in Quang Nam, Central Vietnam. Methodology/Principal Findings P. vivax mono infections collected from 234 individuals between April 2009 and December 2010 were successfully analyzed using a panel of 14 microsatellite markers. Isolates displayed moderate genetic diversity (He = 0.68), with no significant differences between study communities. Polyclonal ...

Plasmodium vivax Duffy binding protein (DBP) is an essential ligand for reticulocyte invasion making it a premier asexual blood stage vaccine candidate. However, strain-specific immunity due to DBPII allelic variation may complicate vaccine efficacy, suggesting that an effective DBPII vaccine needs to target immune responses to conserved epitopes that are potential targets of strain-transcending neutralizing immunity. Anti DBPII monoclonal antibodies, which were previously characterized by COS7 cell binding assay as inhibitory and non-inhibitory to DBPII-erythrocyte binding, were mapped to DBPII gene fragment libraries using phage display. Inhibitory mAb 3C9 binds to a conserved conformation-dependent epitope in subdomain 3 while non-inhibitory mAb 3D10 binds to a linear epitope in subdomain 1 of DBPII. More definitive epitope mapping of mAb 3D10 was achieved using a random peptide library displayed on phage. Since DBP region II is mostly made up of alpha-helices, we used a randomized helical scaffold

New drug regimens are needed for effective prophylaxis and treatment of drug resistant Plasmodium falciparum and Plasmodium vivax malaria in northeastern Papua. Mefloquine and doxycycline, two standard prophylactic drugs, had high prophylactic efficacy in northeastern Papua but they have limited application for two vulnerable groups, young children and pregnant women. Azithromycin, an azalide antibiotic, had a prophylactic efficacy of 83% against P. falciparum in malaria immune Kenyans. If successful in non immunes, it would be a significant addition to the current prophylactic drugs. Chloroquine, the current first line drug in northeastern Papua, is associated with high rates of treatment failure for falciparum and vivax malaria. Cure rates might be improved by combining with chloroquine with doxycycline, two drugs that are inexpensive and widely available. Methods. Two clinical trials were conducted. (1). The prophylactic efficacy of azithromycin against P. falciparum and P. vivax was ...

In vitro susceptibility tests provide information on the intrinsic response of Plasmodium vivax to antimalarials, free from confounding factors such as host immunity or relapse. This study examined the utility of radioisotope and PicoGreen assays as alternatives to the traditional microscopic examination for assessing response of P. vivax to antimalarial drugs. There was no significant difference in the mean chloroquine IC50 of P. vivax (n = 40) as determined by the microscopic (33.4 ng/ml), isotopic (33.6 ng/ml), and PicoGreen (39.1 ng/ml) assays, respectively (F = 0.239, df = 2, 51, and p = 0.788). However measurement of IC50s by the microscopic method was slightly more successful in producing valid assays (57%), compared to the isotopic (32.5%) and PicoGreen (45.5%) methods. In a paired comparison of 20 fresh and cryopreserved isolates as examined by the microscopic method, there were no significant differences between the mean IC50 responses (T = 1.58, df = 15, and p = 0.34). Detailed ...

According to the recent World Malaria Report 2015, around 234 million people are at high risk of malaria in Southeast Asia. The region accounted for 10 percent of global malaria cases and seven percent of deaths in 2015.. There are two types of malaria that cause the most concern in the region - and both can be deadly. Seventy-four percent of P. vivax malaria cases occur in Southeast Asia. P. falciparum resistance to artemisinin, the most effective treatment, is also of grave concern in the region and has now been detected in five countries in the Greater Mekong Subregion (GMS): Cambodia, Lao Peoples Democratic Republic, Myanmar, Thailand and Vietnam.. Malaria can be transmitted by biting mosquitoes during indoor and outdoor activities. However, current malaria vector control policy relies almost entirely on methods that address indoor feeding and resting mosquitoes through indoor residual spraying and insecticide treated mosquito nets. National malaria control programmes are finding that ...

TY - JOUR. T1 - Risk factors and outcomes stratified by severity of acute kidney injury in malaria. AU - Saravu, Kavitha. AU - Rishikesh, Kumar. AU - Parikh, Chirag R.. PY - 2014/3/13. Y1 - 2014/3/13. N2 - Severe acute kidney injury (AKI) is known to have prognostic value for in-hospital outcomes in malaria. However, little is known about the association of AKI of lesser severity with malarial risk factors and outcomes - and such a gap is becoming increasingly relevant with the upsurge in the incidence of AKI due to Plasmodium falciparum malaria and Plasmodium vivax malaria over the last decade. We aimed to identify risk factors of AKI in malaria and assessed in-hospital outcomes stratified by severity of AKI. We performed an observational study of 1,191 hospitalized malaria patients enrolled between 2007 and 2011 in a tertiary care academic center in India. Patients were categorized based on peak serum creatinine into one of three groups: no AKI (,1.6 mg/dL), mild AKI (1.6-3.0 mg/dL), and ...

P. vivax penetrates young red blood cells (reticulocytes) differing from the more commonly studied P. falciparum which invades erythrocytes. once released P. vivax uses 2 proteins to achieve this (PvRBPP-1 and PvRBP-2) and the Duffy blood group antigens (Fy6) to penetrate the red blood cells. Once inside to synthesize its proteins P. vivax obtains its amino acids through de novo synthesis (where complex molecules are formed from simple molecules), import from host plasma, and digestion of host hemoglobin then replicates asexually till the red blood cell ruptures, this swelling forms red blood cells larger in size identifiable through dotting on their surface call Schüffners dots as seen within the trophozoite stage figure. ...

The present study clearly demonstrated that population structure of P. vivax isolates from YL and CB were highly different and the genetic diversity of YL isolates was lower than the other 3 Provinces. YL is geographically more isolated than MH, CB, and KN; they are separated by 2,008, 1,329, and 1,098 km, respectively. This is concordance to the epidemiology of malaria transmission in Yala Province. YL locates in the southern part of Thailand bordered to Malaysia while CB locates in the eastern part bordered to Cambodia. Occupation, climate, and culture of people in YL are different from people in MH, KN, and CB. Today, most southern Muslims work in their own rubber plantations or are hired as rubber tappers if they do not have their own land. The way of life of Muslims in the southern border province is different from those of other groups in the country. Malaria patients in YL mostly were indigenous cases infected in rubber plantation areas of the Province. Migration of people is a probably ...

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Ninety percent of malaria deaths occur in Africa and disproportionately affect pregnant women and young children. Approximately 125 million pregnancies occur each year in areas with P. falciparum and/or P. vivax malaria transmission; 10,000 of these women and 200,000 of their newborns will die as a result of malaria during pregnancy.Malaria in pregnancy (MIP) contributes to maternal anemia, maternal death, stillbirth, spontaneous abortion, and low birth weight.In areas of stable malaria transmission, babies are more likely to be small for gestational age, and in areas of unstable malaria transmission, they are more likely to be born preterm. One-third of all neonatal deaths in malaria endemic regions of Africa are due to low birth weight associated with P. falciparum infections during pregnancy. Key approaches to reduce the burden of malaria for pregnant women, their newborns and young children include: intermittent preventive treatment of pregnant women (IPTp) in areas of stable malaria ...

Ogwu, D.; Osori, D.I.K.; Njoku, C.O.; Ezeokoli, C.D.; Kumi Diaka, J., 1986: Effects of the productive status in zebu heifers on the immunoglobulin M and G levels in bovine Trypanosoma vivax infection

A 26-year-old woman with 29 weeks gestation presented with headache, photophobia and fever. She had deranged liver function tests and low platelets on admission. Blood film, performed to look for haemolysis, revealed she had Plasmodium vivax malaria, despite not having travelled to an endemic malaria area for over 1 year. The diagnosis was confirmed on PCR test performed in the HPA malaria reference laboratory in London and she was treated with chloroquine. She delivered a healthy baby at 33+3 weeks gestation, and once the patient and the baby had both tested negative for glucose-6-phospate dehydrogenase deficiency, she was given primaquine to clear the hypnozoite phase in the liver. This case highlights the importance of an extended travel history in a patient with fever of unknown origin and the difficulties of treating non-falciparum malaria in pregnancy. ...

title:Hematological Changes in P.Falciparum & P.Vivax Malaria. Author:Ameekumari Patel, Sudha Jain, Bhavin Patel, Bhautik Modi. Keywords:Plasmodium Falciparum, Plasmodium Vivax, Haematological Profile, Malaria. Type:Original Article. Abstract:Introduction: Malaria continues to be a great health problem in some of the most populated areas of the world & continues to cause significant morbidity and mortality worldwide. The hematological abnormalities that have been reported to consistently with malaria are anemia, thrombocytopenia, atypical lymphocytosis and infrequently disseminated intravascular coagulation. Methodology: This cross sectional study was conducted in central hospital laboratory of a tertiary care hospital of Surat, Gujarat. The laboratory confirmed cases of malaria from August to October, 2012 were included in the study. Hematological profile of different spices of malaria was compared. Results: The difference in mean platelet count according to severity of infection was highly ...

Malaria during pregnancy due to Plasmodium falciparum or P. vivax is a major public health problem in endemic areas, with P. falciparum causing the greatest burden of disease. Increasing resistance of parasites and mosquitoes to existing tools, such as preventive antimalarial treatments and insecticide-treated bed nets respectively, is eroding the partial protection that they offer to pregnant women. Thus, development of effective vaccines against malaria during pregnancy is an urgent priority. Relevant animal models that recapitulate key features of the pathophysiology and immunology of malaria in pregnant women could be used to accelerate vaccine development ...

Reticulocyte-derived exosomes (Rex) vaccines against P. vivax. We previously found that exosomes derived from reticulocytes infected with malaria parasites can induce a long-lasting protective immune response. More recently, we determined the proteome of plasma-derived exosomes from P. vivax patients and of human reticulocyte exosomes and showed that they contain MHC class I molecules that are actively uptaken by human dendritic cells. We are pursuing efforts to tailor human Rex with P. vivax antigens and determine their potential as a new delivery platform for P. vivax vaccines. (Martin-Jaular et al., Plos One 2011, Diaz-Varela et al., Sci. Rep 2018 ...

General Surveillance During 1997, CDC received reports of 1,544 malaria cases that had onset of symptoms among persons in the United States and its territories, representing a 10.9% increase from the 1,392 cases reported for 1996 (7). This incidence is the largest number of reported cases since 1980. In 1997, a total of 698 cases occurred in U.S. civilians compared with 618 cases reported for 1996. This incidence represents the largest number of U.S. civilian cases reported since 1968 (Table 1). The number of cases in foreign civilians decreased from 636 in 1996 to 592 in 1997 (Figure 1). Cases among U.S. military personnel also decreased from 32 in 1996 to 28 in 1997. In 226 cases, civilian or military status was not reported. Plasmodium Species The infecting species of Plasmodium was identified in 1,410 (91.3%) of the cases reported in 1997. P. vivax and P. falciparum were identified in blood smears from 48.9% and 36.7% of infected persons, respectively (Table 2). The 755 P. vivax cases ...

Origin of outbreak. On March 4, 2005, a 41-year-old male patient was admitted to a hospital in Monte Alegre de Minas with symptoms of fever, chills and sweating. The diagnosis from blood tests performed at the reference laboratory in Uberlândia, Minas Gerais, was that the patient presented Plasmodium vivax. Epidemiological investigations confirmed that the patient did not have any history of traveling in areas where malaria transmission is endemic. In addition, it was confirmed that no risk factors such as blood transfusion, blood derivative transfusion, organ transplantation or previous malaria infections were present. It was suspected that there might be other autochthonous malaria cases, and an epidemiological investigation was started, directed by the State Health Department of Minas Gerais. On March 9, 2005, another case of infection by Plasmodium falciparum was confirmed, in a patient in hospital in the municipality of Uberlândia who had come from the municipality of Prata, thus ...

Malaria prevention and control strategies are being implemented robustly in the endemic provinces; however, similar strategies in the non-endemic provinces are lagging behind. This paper provides advice on the key measures for malaria prevention and management. Successful malaria treatment is dependent on a high index of suspicion for malaria in patients with acute febrile illness, and urgent treatment with effective medication.. Prevention of malaria. Travellers to malaria areas in southern Africa will be particularly vulnerable as the malaria risk season peaks in the coming months; therefore emphasis should be placed on prevention. Measures to avoid mosquito bites are the mainstay of malaria prevention and should be emphasised at all times. Whether or not appropriate chemoprophylaxis is warranted, should be determined by weighing up the risk of contracting malaria against the risk of adverse effects. Malaria risk is determined by travel location and accommodation, as well as season and length ...

Malaria therapy, experimental, and epidemiological studies have shown that erythrocyte Duffy blood group-negative people, largely of African ancestry, are resis

World Malaria Day (WMD) is an international day which is celebrated every year on 25th April and recognizes global efforts to control malaria. World Malaria Day was established in May 2007 by the 60th session of the World Health Assembly, WHO decision-making body. The day was established to provide education and understanding of malaria and spread information on year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas. World Malaria Day allows for corporations, multinational organizations and grassroots organizations globally to work together to bring awareness to malaria and advocate for policy changes.. Since 2000, malaria affected countries and their development partners have made remarkable progress in reducing the total number of malaria cases and death. But the toll of malaria remains unacceptably high. Every two minutes, a child dies of this preventable and treatable disease, ...

All are true for Malaria parasites except: (a) P. knowlesi is now recognised as the fifth Plasmodium species that causes human malaria., (b) Plasmodium ovale Malaria is responsible for most fatalities., (c) P. vivax and P. ovale , both of which cause benign tertian malaria., (d) Individuals who are heterozygous for the sickle cell and thalassaemia genes have much-reduced susceptibility to infectio

Malaria Reports is a peer-reviewed international medical journal devoted entirely to the study diagnosis, and treatment of malaria. The journal covers all aspects of malaria, including the pathophysiology, diagnosis, classification, epidemiology, and treatment of malaria for physicians and medical scientists. The journal tries to attract papers on malaria in its broadest sense. The journal welcomes papers that:. - provide malaria burden estimates and ways to improve the burden estimation (i.e. using optimal diagnostic tests).. - provide a better understanding of malaria, especially explaining the complex interaction between humans, vectors, climate and the environment. Studies incorporating e.g. socio-economic determinants are strongly encouraged. In line with this objective, we will appreciate papers reporting on interventions against malaria and clinically relevant information that will directly improve the care of patients with malaria.. - report on existing malaria information systems and ...

In humans, malaria causes fevers, liver problems, breathing issues, and death. Malaria also leads to billions in economic impact in the areas in which it is present. These impacts include lost productivity and earning power of those afflicted or killed by malaria, the health investments needed to combat malaria, and tourism being deterred by a fear of malaria.. In 2018, more than 228 million cases of malaria were recorded and over 400,000 people around the world died from it.. The majority of the most common mosquito vectors of malaria (all species within the Anopheles genus) live and thrive in Africa, particularly sub-Saharan Africa. Its possible that they have evolved alongside humans during mankinds long history in Africa to become even more efficient at transmitting malaria.. Until recently, most of the malaria outbreaks in sub-Saharan Africa had been in rural or semi-rural areas. Scientists believe that this was the majority of the population in this area lived in rural areas. This is ...

ODonnell, J. and Goldman, J.M. and Wagner, K. and Ehinger, G. and Martin, Neil D. T. and Leahy, M. and Kariuki, N. and Roberts, I. (1998) Donor-derived Plasmodium vivax infection following volunteer unrelated bone marrow transplantation. Bone Marrow Transplantation, 21 (3). pp. 313-314. ISSN 0268-3369. (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided ...

Image courtesy of CDC/ Dr. Mae Melvin. Two schizonts are visible in the image below, immature on left and mature on right. Merozoites are undergoing development in these two infected erythrocytes.. ...

DUO-COTECXIN/8T,Antimalarials,Products,NEWZADD2014011500067,Used in the treatment of uncomplicated falciparum malaria and vivax malaria.