Volume 79, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The gametocytocidal and asexual stage activities of eight antimalarial and eight antibiotic-containing regimens were evaluated in 349 adult patients with malaria. Gametocytemia was found in 63% of patients (22% before and 41% after treatment). The median (range) gametocyte clearance time was 24 hours (range, 2–504 hours) and correlated with asexual parasite clearance time ( = 0.52, < 0.001). Gametocytemia in vivax malaria was more common in patients with admission parasitemia > 10,000/μL and after treatment with drugs which have weak antimalarial activity, and was also associated with an increased rate of vivax reappearance (29.4% versus 14.1%, = 0.002). Sexual stage activities corresponded with asexual stage activity for all tested regimens. Treatment with potent antimalarial drugs reduces the transmission potential of


Article metrics loading...

Loading full text...

Full text loading...



  1. Baird JK, Leksana B, Masbar S, Fryauff DJ, Sutanihardja MA, Suradi, Wignall FS, Hoffman SL, 1997. Diagnosis of resistance to chloroquine by Plasmodium vivax: timing of recurrence and whole blood chloroquine levels. Am J Trop Med Hyg 56 : 621–626.
  2. Ratcliff A, Siswantoro H, Kenangalem E, Maristela R, Wuwung RM, Laihad F, Ebsworth EP, Anstey NM, Tjitra E, Price RN, 2007. Two fixed-dose artemisinin combinations for drug-resistant falciparum and vivax malaria in Papua, Indonesia: an open-label randomised comparison. Lancet 3 : 757–765.
  3. Dua VK, Kar PK, Sharma VP, 1996. Chloroquine resistant Plasmodium vivax malaria in India. Trop Med Int Health 1 : 816–819.
  4. Soto J, Toledo J, Gutierrez P, Luzz M, Llinas N, Cedeno N, Dunne M, Berman J, 2001. Plasmodium vivax clinically resistant to chloroquine in Colombia. Am J Trop Med Hyg 65 : 90–93.
  5. Akim NI, Drakely C, Kingo T, Simon B, Senkoro K, Sauerwein RW, 2000. Dynamics of gametocyte carriage in symptomatic patients in an area of intense perennial transmission in Tanzania. Am J Trop Med Hyg 63 : 199–203.
  6. Drakeley CJ, Secka I, Correa S, Greenwood BM, Targett GAT, 1999. Host haematological factors influencing transmission of Plasmodium falciparum gametocytes to Anopholes gambiae ss mosquitoes. Trop Med Int Hlth 4 : 131–138.
  7. Boyd MF, Kitchen SF, 1937. On the infectiousness of patients infected with Plasmodium vivax and Plasmodium falciparum. Am J Trop Med 17 : 253–263.
  8. Boyd MF, Stratman-Thomas WK, Muench H, 1935. The occurrence of gametocytes of Plasmodium vivax during the primary attack. Am J Trop Med 16 : 133–138.
  9. Mckenzie FE, Wongsrichanalai C, Magill AJ, Forney JR, Permpanich B, Lucas C, Erhart LM, O’Meara WP, Smith DL, Sirichaisinthop J, Gasser RA Jr, 2006. Gametocytemia in Plasmodium vivax and Plasmodium falciparum infections. J Parasitol 92 : 1281–1285.
  10. McKenzie FE, Jeffery GM, Collins WE, 2007. Gametocytemia and fever in human malaria infections. J Parasitol 93 : 627–633.
  11. Pukrittayakamee S, Chotivanich K, Chantra A, Clemens R, Looareesuwan S, White NJ, 2004. Activities of artesunate and primaquine against asexual- and sexual-stage parasites in falciparum malaria. Antimicrob Agents Chemother 48 : 1329–1334.
  12. Suputtamongkol Y, Chindarat S, Silpasakorn S, Chaikachonpatd S, Lim K, Chanthapakajeem K, Kaewkaukul N, Thamlikitkul V, 2003. The efficacy of combined mefloquine-artesunate versus mefloquine-primaquine on subsequent development of Plasmodium falciparum gametocytemia. Am J Trop Med Hyg 68 : 620–623.
  13. Price R, Nosten F, Simpson JA, Luxemburger C, Phaipun L, ter Kuile F, van Vugt M, Chongsuphajaisiddhi T, White NJ, 1999. Risk factors for gametocyte carriage in uncomplicated falciparum malaria. Am J Trop Med Hyg 60 : 1019–1023.
  14. Mendez F, Munoz A, Carrasquilla G, Jurado D, Arevalo-Herrera M, Cortese JF, Plowe CV, 2002. Determinants of treatment response to sulfadoxine-pyrimethamine and subsequent transmission potential in falciparum malaria. Am J Epidemiol 156 : 230–238.
  15. Covell G, Coatney GR, Field JW, Singh J, 1995. Chemotherapy of malaria. WHO Monogr Ser 27 : 1–123.
  16. Chotivanich KT, Silamut K, Udomsangpetch R, Stepniewska K, Pukrittayakamee S, Looareesuwan S, White NJ, 2001. Ex-vivo short term culture and development assessment of Plasmodium vivax. Trans R Soc Trop Med Hyg 95 : 677–680.
  17. Russell B, Chalfein F, Prasetyorini B, Kenangalem E, Piera K, Suwanarusk R, Brockman A, Prayoga P, Sugiarto P, Cheng Q, Tjitra E, Anstey NM, Price RN, 2008. Determinants of in vitro drug susceptibility testing of Plasmodium vivax. Antimicrob Agents Chemother 52 : 1040–1045.
  18. Pukrittayakamee S, Chantra A, Simpson JA, Vanijanonta S, Clemens R, Looareesuwan S, White NJ, 2000. Therapeutic responses to different antimalarial drugs in vivax malaria. Antimicrob Agents Chemother 44 : 1680–1685.
  19. Pukrittayakamee S, Clemens R, Chantra A, Nontprasert A, Laknam T, Looareesuwan S, White NJ, 2001. Therapeutic responses to antibacterial drugs in vivax malaria. Trans R Soc Trop Med Hyg 95 : 524–528.
  20. Imwong M, Snounou G, Pukrittayakamee S, Tanomsing N, Kim JR, Nandy A, Guthmann JP, Nosten F, Carlton J, Looareesuwan S, Nair S, Sudimack D, Day NP, Anderson TJ, White NJ, 2007. Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites. J Infect Dis 195 : 927–933.
  21. Pukrittayakamee S, Vanijanonta S, Chantra A, Clemens R, White NJ, 1994. Blood stage antimalarial efficacy of primaquine in Plasmodium vivax malaria. J Infect Dis 169 : 932–935.
  22. Nacher M, Silachamroon U, Singhasivanon P, Wilairatana P, Phumratanaprapin W, Fontanet A, Looareesuwan S, 2004. Risk factors for Plasmodium vivax gametocyte carriage in Thailand. Am J Trop Med Hyg 71 : 693–695.
  23. Piyaphanee W, Krudsood S, Tangpukdee N, Thanachartwet W, Silachamroon U, Phophak N, Duangdee C, Haoharn O, Faithong S, Wilairatana P, Leowattana W, Looareesuwan S, 2006. Emergence and clearance of gametocytes in uncomplicated Plasmodium falciparum malaria. Am J Trop Med Hyg 74 : 432–435.
  24. Sattabongkot J, Maneechai N, Rosenberg R, 1991. Plasmodium vivax: gametocyte infectivity of naturally infected Thai adults. Parasitology 102 : 27–31.
  25. Price RN, Nosten F, Luxemburger C, ter Kuile FO, Paiphun L, Chongsuphajaisiddhi T, White NJ, 1996. Effects of artemisinin derivatives on malaria transmissibility. Lancet 347 : 1654–1658.
  26. Alving AS, Arnold J, Hockwald RS, Clayman CB, Dern RJ, Beutler E, Flanagan CL, 1955. Potentiation of the curative action of primaquine in vivax malaria by quinine and chloroquine. J Lab Clin Med 46 : 301–306.

Data & Media loading...

  • Received : 24 Jan 2007
  • Accepted : 02 Jun 2008

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error