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Concealed Erythrocytic Parasites and Elimination of Plasmodium vivax

December 22, 2021 - 22:53 -- Miles Markus

In the malaria research field, prior events are sometimes overlooked (or ignored). Being formerly of a mild disposition (not always entirely so now, if provoked by displays of poor ethics), thirty years elapsed before I drew attention to one of these events. An analogy is that when you tread on the tail of a dinosaur, there can be a long delay before it turns its head.

This aside, another such malarial event is the recognition that hidden erythrocytic parasites are a problem (i.e. in addition to hypnozoites) in relation to the control, elimination and eradication of Plasmodium vivax and the infection it causes.

The subject has been discussed or otherwise covered in at least four 2021 articles. The thought is not new, however.

Note that the first paper to expound at length on the matter and from various angles [1] was published in 2017 (it was not cited in any of the abovementioned four articles, hence attention is being drawn to it). This happened before the extent of the phenomenon of the presence of sequestered and extravascular asexual P. vivax stages became apparent.

The abstract of the 2017 paper [1] reads:

"Accumulation of erythrocytic parasites in bone marrow and the spleen has been reported in cases of Plasmodium vivax malaria. If this occurs commonly, these stages represent a possible source of early, relapse-like homologous recurrences. Moreover, they might hinder the elimination of malaria from human populations. Pertinent research suggestions have been made."



1. "Malaria eradication and the hidden parasite reservoir". Trends in Parasitology 2017; 33 (7): 492–495.