Severe vivax malaria, once considered a relatively benign infection compared to its counterpart P. falciparum, has emerged as a significant health concern with severe and life-threatening complications. Historically, P. vivax was thought to cause mild symptoms without severe complications or fatalities. However, a pivotal study from India in 2005 provided firm evidence of severe complications such as cerebral malaria, renal failure, severe anemia, and pregnancy-related issues in patients with PCR-confirmed P. vivax monoinfection. Subsequent reports from countries like Brazil, Indonesia, and Thailand have corroborated these findings, highlighting the global prevalence of severe vivax malaria. Despite these observations, there remains a marked uncertainty over the true incidence, prevalence, and outcomes due to a lack of comprehensive clinical and epidemiological research. The pathogenesis of this low-density parasitic infection is not well understood, necessitating further investigation into its complex biology and the factors contributing to its severe manifestations.

This Research Topic aims to elucidate the epidemiological and clinical patterns of severe P. vivax infections, understand the underlying pathogenesis, and identify factors contributing to severe outcomes. Specific questions include the incidence and prevalence of severe vivax malaria, the role of comorbidities and coinfections, and the impact of delayed diagnosis and treatment. Hypotheses to be tested involve the potential similarities in the risk of severe disease and mortality between P. vivax and P. falciparum infections, as well as the influence of genetic, immunological, and environmental factors on disease severity.

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

- Epidemiology and clinical presentation patterns
- Role of climatic and environmental conditions and vectors
- Community treatment-seeking behavior
- Impact of delayed diagnosis and treatment
- Effect of comorbid conditions and coinfections
- Association with pregnancy, immune status, and nutritional status
- Severe vivax malaria in travelers
- Transcriptomics, proteomics, genomics, metabolomics, and immunological studies in host and parasite
- Systems biology and molecular surveillance of P. vivax drug resistance markers
- Studies on hidden reservoirs of P. vivax (spleen and bone marrow)
- Culture and transfection studies for a better understanding of P. vivax biology

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