Relapses of <i>Plasmodium vivax</i> malaria threaten disease elimination: time to deploy tafenoquine in India?
Sundus Shafat Ahmad, Manju Rahi, Amit Sharma
Abstract
### Summary Millions suffer from the scourge of malaria across the world, reflected by the estimated 228 million cases and 0.4 million deaths it caused in 2018, as reported in the World Malaria Report 2019. India and African nations shouldered 85% of the world’s malaria burden in 2018. The South-East Asia Region recorded a 70% decrease in malaria incidence from 2010 (17 cases/1000 population) to 2018 (5 cases/1000 population). Despite the absolute reduction in India’s malaria cases, with 2.6 million fewer cases in 2018 than in 2017, India’s malaria burden still remains considerable at an estimated 6.7 million cases.1 Out of all the global Plasmodium vivax burden, 53% is in the WHO South-East Asia Region, India accounting for 47% and is a major cause of health burden in these countries.1 P. vivax malaria is now known to cause considerable morbidity and mortality due to severe malaria.2 In addition, due to relapses P. vivax causes additional burden on disease burden and feeds transmission. Despite the problem of P. vivax , malaria control have hitherto focused more on P. falciparum . It is likely that this burden will increase in 2020–2021 due to diversion of public health attention towards COVID-19. At the same time, there is a potential for several cross-learnings between malaria and COVID-19.3 4 Nonetheless, P. vivax continues to …