Epidemiological aspects of vivax and falciparum malaria: global spectrum

Malaria, a mosquito-borne disease, is caused by the infection of apicomplexan parasites belonging to the genus Plasmodium, five species of which [Plasmodium vivax, Plasmodium falciparum (P. falciparum), Plasmodium ovale, Plasmodium malariae and Plasmodium knowlesi] account for all forms of human malaria. P. falciparum is responsible for the highest degree of complications (severe malarial anaemia and cerebral malaria) and mortality in the tropics and subtropics of the world. Despite the large burden of vivax malaria, it is overlooked and left in the shadow of severity of falciparum malaria in the globe, but current reports provide evidence of severe vivax malaria symptoms similar to P. falciparum infection. The major challenging factor is the emergence of multidrug resistant Plasmodium strains to the conventionally used antimalarials over the last two decades, and, more recently, to artemisinins. The WHO recommended artemisinin based combination therapies (ACTs). The non-ACT regimens are also found to be effective, safe, and affordable compared to ACTs. However, current successful antimalarial interventions are under threat from the ability of the parasite and its mosquito vector to develop resistance to medicines and insecticides, respectively. Hence, with widespread use of effective drugs and vector control with insecticide-treated bed nets and indoor residual spraying, an ideal malaria vaccine would be the actual means of malaria prevention. This review represents the current evidence, based upon the search of SCI-and non-SCI journal, on epidemiological aspects of two forms (vivax and falciparum) of human malaria, which is still a great global concern.