The clinically silent Plasmodium vivax reservoir in the Amazon: a systematic review and pooled analysis of individual-level data from population-based surveys
Explore the large volume of individual-level data generated by population-based surveys in endemic settings in Brazil and Peru combined with aggregated data to provide an accurate and up-to-date estimate of the relative contribution of asymptomatic infections to the overall P. vivax burden and transmission in the area.
The burden of malaria has been greatly reduced in the world and in Latin America over the past two decades, however residual transmission (Plasmodium vivax in >80% of cases) continues to occur across the Amazon Basin. Over the past decade, the research groups in this project have investigated challenges to malaria control and elimination in Brazil and in Peru using population-based studies. The two settings are different in epidemiological characteristics of malaria transmission, local ecologies and human behaviors, but similar in the high proportion of asymptomatic infections that are observed and form a human reservoir of infection, which remain undetected and untreated by strategies currently used to control malaria in the region. Many research questions on the epidemiology and the impact of P. vivax asymptomatic infections on transmission in the region remain incompletely understood, e.g. relation between intensity of transmission and proportion of asymptomatic infections, fever thresholds, changes with age…. We propose to systematically explore these questions using population based data generated by the collaborating investigators combined with data (from across the Amazon) generated by others. We will accurately measure the burden of asymptomatic infections and their relative contribution to transmission in the area. Results will advance knowledge on malaria epidemiology in the region and contribute to improve strategies aiming to eliminate malaria.