Improving the treatment of Plasmodium vivax

My current Fellowship has documented the public health importance of P. vivax and the comparative efficacy of alternative treatment regimens that will be needed for its elimination. In my next Fellowship I will determine the key translational elements required to implement these treatments safely and effectively. I will build upon an established collaborative clinical trials network, to conduct complementary studies with three integrated themes: 1) Studies to quantify the risks of P. vivax recurrence and the associated haemolysis attributable to the infection versus its treatment. These data will define the risk benefit of primaquine use in different endemic settings. 2) Investigation of the spectrum of G6PD deficiency and how this relates to genetic variants and the risk of drug induced haemolysis. These studies will improve population based surveillance and bedside diagnosis. 3) Laboratory studies to identify the molecular determinants of chloroquine resistance, to enable better surveillance of drug-resistant P. vivax. Identifying patients at greatest risk of recurrence and primaquine-induced haemolysis will ensure management strategies can be revised accordingly. My objective is that these tools will be endorsed by the WHO, adopted by National Malaria Control Programmes and become integral to current global malaria elimination efforts.