Challenges and Advances in P. vivax Malaria Elimination

Plasmodium vivax malaria remains a significant public health challenge, particularly outside Africa, despite global efforts towards malaria elimination. Since the World Health Organization's renewed call for malaria elimination in 2016, 12 countries have been declared malaria-free. However, P. vivax presents unique challenges due to its hypnozoite stage, where dormant parasites in the liver evade standard treatments and diagnostics, leading to relapses. This stage complicates elimination efforts, as it requires the use of 8-aminoquinolines, which are further complicated by interactions with G6PD deficiency and CYP2D6 polymorphisms. The absence of diagnostic tests for hypnozoites means that individuals harboring these dormant parasites remain a hidden source of transmission. Additionally, P. vivax gametocytes can emerge early from the bone marrow, allowing transmission before clinical symptoms appear, thus reducing the effectiveness of early diagnosis and treatment. In some endemic regions, asymptomatic P. vivax infections can reach a prevalence of 50%, further complicating elimination efforts. Recent studies have shown that while global malaria incidence has stabilized since 2020, reductions in P. vivax cases continue in parts of Asia, Southeast Asia, and the Americas. To sustain these gains, there is a critical need to enhance our understanding of P. vivax biology, improve clinical management, and develop new diagnostics and therapeutics.

This Research Topic aims to compile the latest findings on the diverse aspects of P. vivax malaria and how they translate to support malaria elimination. Specifically, we seek to address key questions such as: What are the genetic and biological mechanisms underlying P. vivax's resilience? How do host-pathogen interactions influence disease progression and transmission? What are the most effective strategies for diagnosing and treating hypnozoite stages? By answering these questions, we aim to develop a comprehensive understanding that can inform better clinical management and treatment strategies, ultimately contributing to the global goal of malaria elimination.

To gather further insights into the complexities of P. vivax malaria, we welcome articles addressing, but not limited to, the following themes:

- Genetics and biology
- Disease models (e.g., murine, cultures, organoids)
- Host-pathogen interactions (in humans and mosquitoes)
- Hidden reservoirs (e.g., bone marrow, liver, spleen) and hypnozoite biology
- Pathogenesis and clinical studies
- Diagnostics, drugs, and vaccines
- Epidemiology
- Policy

Authors are encouraged to submit their work in various formats, including Original Research, Methods, Perspective, Opinion, Hypothesis and Theories, Brief Reports, and Regular, Systematic, and Mini Reviews.

Keywords: malaria, plasmodium vivax, epidemiology, malaria elimination, parasite, disease pathogenesis

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.