부산대학교 도서관

There has been progress towards decreasing malaria prevalence globally; however, Plasmodium vivaxhas been less responsive to elimination efforts compared with Plasmodium falciparum. P. vivaxmalaria remains a serious public health concern in regions where it is the dominant species (South and South-East Asia, the Eastern Mediterranean region, and South America) and is increasingly recognized for its contribution to overall morbidity and mortality worldwide. The incidence of P. vivaxdecreases with increasing age owing to rapidly acquired clinical immunity and there is a disproportionate burden of P. vivaxin infants and children, who remain highly vulnerable to severe disease, recurrence, and anemia with associated developmental impacts. Diagnosis is sometimes difficult owing to the sensitivity of diagnostic tests to detect low levels of parasitemia. Additionally, the propensity of P. vivaxto relapse following reactivation of dormant hypnozoites in the liver contributes to disease recurrence in infants and children, and potentiates morbidity and transmission. The 8-aminoquinolines, primaquine and tafenoquine, provide radical cure (relapse prevention). However, the risk of hemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency necessitates testing prior to administration of 8-aminoquinolines, which has limited their uptake. Additional challenges include lack of availability of pediatric dose formulations and problems with adherence to primaquine owing to the length of treatment recommended. A paucity of data and studies specific to pediatric P. vivaxmalaria impacts the ability to deliver targeted interventions. It is imperative that P. vivaxin infants and children be the focus of future research, control initiatives, and anti-malarial drug development.