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2016 Update: Another Malaria Elimination Problem

April 21, 2016 - 09:44 -- Miles Markus

This is a comment concerning the hidden parasite reservoir, and it is partly drug-related.

Since the 1980s, it has conventionally been stated that hypnozoites are found in the life cycles of Plasmodium vivax and P. ovale but not in those of P. falciparum, P. knowlesi or P. malariae; and that hypnozoites are therefore the source of relapse-type recurrent malaria in P. vivax and P. ovale infections only. In the light of particular research findings during the past 20 years, but especially of studies reported in some recent publications (referenced here), this is in retrospect almost certainly an inadvertently simplistic evaluation of the overall situation. Hypnozoites might also occur in the life cycles of species of Plasmodium that are traditionally thought not to have them (see 2016 explanation here as well as Richter et al., 2016). That matter aside, some latent non-hypnozoite parasites probably have extra-hepatic, non-bloodstream human cells as their habitat. These stages are not necessarily always killed by drugs (elaborated upon here). How, then, will this "additional" hidden reservoir of infection in human populations be dealt with? It might not be possible to do much about it.

These two subjects need to be addressed. Suggestions for initial experimentation using modern technology were published this month (see details here).