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How Many Cases of Plasmodium vivax Malaria are Relapses?

November 17, 2020 - 22:35 -- Miles Markus

Are up to 80% or more of detectable Plasmodium vivax malarial recurrences relapses (a relapse being a hypnozoite-mediated recurrence)? This is a topical matter and a very interesting question.

The answer is that it is indeed a distinct possibility. The prevailing idea that recurrent bouts of P. vivax malaria are predominantly relapses is an assumption which is extremely tempting to make. It is based primarily on compelling data involving drug treatment with primaquine. Nevertheless, the assumption is not necessarily correct. Reasons why conceivably not are provided here (click on link):

https://doi.org/10.1016/j.pt.2019.08.009

The bottom line is that there is not yet any definitive proof, one way or the other, as to whether non-reinfection P. vivax malarial recurrences are mostly relapses (as opposed to recrudescences). The jury is still out on this.

Comments

Submitted by Anonymized User (not verified) on

It cannot be disputed that what seems likely and something which has actually been proven are different conclusions. The former is a calculated guess and the latter would be (if proven) a fact (hard science).

So considering that there is an additional possible explanation for parasite killing by primaquine (contained in the thought-provoking publication for which a website link is given in the blog), the seemingly entirely logical relapse percentage assumption should nevertheless not at this point be over-interpreted by expressing it as a fact.

It is not a known fact. At least not yet (if the assumption is correct), as indicated in the blog.