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Can treatment of P. vivax lead to a unexpected appearance of falciparum malaria?

April 26, 2017Appearance falciparum lead malaria treatment unexpected vivax

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Can treatment of P. vivax lead to a unexpected appearance of falciparum malaria?

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Mason DP; Krudsood S; Wilairatana P; Viriyavejakul P; Silachamroon U; Chokejindachai W; Singhasivanon P; Supavej S; McKenzie FE; Looareesuwan S Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. dmason@itsa.ucsf.edu Of 994 patients admitted to the Bangkok Hospital for Tropical Diseases for P. vivax malaria, 104 (10.5%) experienced appearance of Plasmodiumfalciparum following drug treatment for P. vivax . In all patients, P. falciparum parasites were not found by microscopic examination upon admission. The mean time for P. falciparum appearance was 12.6 days after the commencement of chloroquine treatment. Patients experiencing appearance of P. falciparum had significantly lower hematocrit, and greater initial P. vivax parasite counts. We use a mathematical model to explore the consequences of chloroquine treatment of such mixed infections. Both clinical results and features of the model suggest that such “hidden infections” may be quite common, and that the appearance