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Plasmodium vivax sub-patent infections after radical treatment are common in peruvian patients: Results of a 1-year prospective cohort study

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dc.contributor.author van den Eede, P.
dc.contributor.author Soto-Calle, V.E.
dc.contributor.author Delgado Ratto, Christopher
dc.contributor.author Gamboa Vilela, Dionicia Baziliza
dc.contributor.author Grande, T.
dc.contributor.author Rodriguez, H.
dc.contributor.author Llanos Cuentas, Elmer Alejandro
dc.contributor.author Anné, J.
dc.contributor.author D'Alessandro, U.
dc.contributor.author Erhart, A.
dc.date.accessioned 2022-01-18T19:34:38Z
dc.date.available 2022-01-18T19:34:38Z
dc.date.issued 2011
dc.identifier.uri https://hdl.handle.net/20.500.12866/11084
dc.description.abstract Background: There is an increasing body of literature reporting treatment failure of the currently recommended radical treatment of Plasmodium vivax infections. As P. vivax is the main malaria species outside the African continent, emerging tolerance to its radical treatment regime could have major consequences in countries like Peru, where 80% of malaria cases are due to P. vivax. Here we describe the results of a 1-year longitudinal follow up of 51 confirmed P. vivax patients living around Iquitos, Peruvian Amazon, and treated according to the Peruvian national guidelines. Methodology: Each month a blood sample for microscopy and later genotyping was systematically collected. Recent exposure to infection was estimated by detecting antibodies against the P. vivax circumsporozoite protein (CSP) and all PCR confirmed P. vivax infections were genotyped with 16 polymorphic microsatellites. Results: During a 1-year period, 84 recurrent infections, 22 positive also by microscopy, were identified, with a median survival time to first recurrent infection of 203 days. Most of them (71%) were asymptomatic; in 13 patients the infection persisted undetected by microscopy for several consecutive months. The genotype of mostly recurrent infections differed from that at day 0 while fewer differences were seen between the recurrent infections. The average expected heterozygosity was 0.56. There was strong linkage disequilibrium (IAs = 0.29, p<1.1024) that remained also when analyzing only the unique haplotypes, suggesting common inbreeding. Conclusion: In Peru, the P. vivax recurrent infections were common and displayed a high turnover of parasite genotypes compared to day 0. Plasmodium vivax patients, even when treated according to the national guidelines, may still represent an important parasite reservoir that can maintain transmission. Any elimination effort should consider such a hidden reservoir. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject cohort analysis en_US
dc.subject Cohort Studies en_US
dc.subject controlled study en_US
dc.subject major clinical study en_US
dc.subject genetics en_US
dc.subject Genotype en_US
dc.subject polymerase chain reaction en_US
dc.subject disease transmission en_US
dc.subject microsatellite marker en_US
dc.subject parasite transmission en_US
dc.subject Plasmodium vivax en_US
dc.subject chloroquine en_US
dc.subject blood en_US
dc.subject Polymerase Chain Reaction en_US
dc.subject haplotype en_US
dc.subject gene frequency en_US
dc.subject genetic association en_US
dc.subject heterozygosity en_US
dc.subject Longitudinal Studies en_US
dc.subject Prospective Studies en_US
dc.subject Malaria, Vivax en_US
dc.subject Plasmodium vivax malaria en_US
dc.subject primaquine en_US
dc.subject Recurrence en_US
dc.subject Antibodies, Protozoan en_US
dc.subject antibody titer en_US
dc.subject recurrent disease en_US
dc.subject circumsporozoite protein en_US
dc.subject gene linkage disequilibrium en_US
dc.subject genetic variability en_US
dc.subject protozoon antibody en_US
dc.subject survival time en_US
dc.title Plasmodium vivax sub-patent infections after radical treatment are common in peruvian patients: Results of a 1-year prospective cohort study en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0016257
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.00
dc.relation.issn 1932-6203


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