Thursday, 30 June 2011

MALARIA: Why Is Plasmodium vivax a Neglected Tropical Disease?

Plasmodium vivax malaria is a debilitating, sometimes life-threatening, and economically repressive disease of many tropical and temperate countries outside Africa, and yet it is perceived as relatively benign. The estimated cost of the global burden of vivax malaria is US$1,400,000,000–$4,000,000,000 per year [1], and more people worldwide live at risk from P. vivax than P. falciparum [2]. All age groups suffer P. vivax infections and endure repeated, incapacitating febrile attacks, severe anemia, and respiratory distress, with poor outcomes in pregnancy and learning impairment in children also apparent. Similar to other neglected diseases, P. vivax affects primarily poor people lacking access to affordable health care, trapping many in a relentless cycle of poverty because of loss of adult productivity and depletion of meager financial reserves [3]–[5]. Global malaria elimination programs are mobilized against P. falciparum, most likely because of the greater mortality rates associated with it, and draw resources away from P. vivax even though vivax malaria is harder to prevent, diagnose, and treat, and both species are co-endemic. There is a consensus among malaria experts that eliminating P. vivax will prove more technically challenging than eliminating P. falciparum [6], and that there exist fewer tools and a weaker knowledge base from which to start an effective global elimination program [7].

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