Recurrent Plasmodium vivax Cases of Both Short and Long Latency Increased with Transmission Intensity and Were Distributed Year-Round in the Most Affected Municipalities of the RACCN, Nicaragua, 2013–2018

Aida M. Soto, Lilia González-Cerón, Frida Santillán-Valenzuela, María E. Parrales and Alberto Montoya
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Aida M. Soto: Centre for Research and Health Studies, National Autonomous University of Nicaragua, Managua 11095, Nicaragua
Lilia González-Cerón: Regional Centre of Research in Public Health, National Institute for Public Health, Tapachula 30700, Chiapas, Mexico
Frida Santillán-Valenzuela: Regional Centre of Research in Public Health, National Institute for Public Health, Tapachula 30700, Chiapas, Mexico
María E. Parrales: Malaria Component, Ministry of Health, Managua 11165, Nicaragua
Alberto Montoya: Parasitology Department, National Centre for Diagnosis and Reference, Ministry of Health, Managua 11165, Nicaragua

IJERPH, 2022, vol. 19, issue 10, 1-18

Abstract: The characteristics of P. vivax recurrent episodes were examined using a centralized secondary source of malaria records in Nicaragua and in the two most affected municipalities in the RACCN. The study of 36,787 malaria cases due to P. vivax or P. falciparum revealed that, nationwide, 3624 patients had at least one recurrent infection. This was achieved by matching names, gender, age, community/municipality, ethnicity, etc. P. vivax was responsible for 88% of recurrent infections of 25–450 days of latency (51.9% were women and 48.1% were men), and these were assumed to be relapse episodes. Of them, 88.2% and 4.4% occurred in the municipalities of Puerto Cabezas and Rosita, respectively. The proportion of P. vivax patients having presumed relapse episodes rose with elevated transmission rates in both municipalities, reaching 7% in Rosita (2017) and 14.5% in Puerto Cabezas (2018). In both areas, relapse episodes were evident over time and were characterized by the production of a continuous stippling pattern with a slope evolving from one transmission peak to the next. During the dry season, short-latency relapse episodes were more robust, while long-latency ones increased just before the P. vivax transmission season began, with a high proportion of long-latency relapses during this period. The abundance of recurrent P. vivax infections, the wide range of relapse latency lengths, and temporal distribution tended to favor year-round transmission. It is necessary to evaluate compliance with and the effectiveness of primaquine treatment and contemplate the use of an alternative drug, among other actions.

Keywords: Plasmodium vivax; recurrent cases; relapse; latency; transmission intensity; malaria cases; secondary case report; Nicaragua (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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