Evidence map›Paper›PMID 30703083›Full record

ArticlePLoS neglected tropical diseases2019

Growing evidence of Plasmodium vivax across malaria-endemic Africa.

Katherine A Twohig, Daniel A Pfeffer, J Kevin Baird, Ric N Price, Peter A Zimmerman, Simon I Hay, Peter W Gething, Katherine E Battle, Rosalind E Howes

Erratum issuedAbstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 119 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
119citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

119 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  17. Integrating parallelCommunications health · 2026
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  18. Adaptive evolution ofbioRxiv : the preprint server for biology · 2025
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59 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Katherine A TwohigMalaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID 0000-0001-9514-0097
Daniel A PfefferMalaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-2204-3488
J Kevin BairdEijkman-Oxford Clinical Research Unit, Eijkman Institute of Molecular Biology, Jakarta, Indonesia.
Ric N PriceGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.ORCID 0000-0003-2000-2874
Peter A ZimmermanThe Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America.
Simon I HayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America.ORCID 0000-0002-0611-7272
Peter W GethingMalaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Katherine E BattleMalaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID 0000-0003-2401-2615
Rosalind E HowesMalaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID 0000-0003-0992-1511

Funding

Madagascar P. vivax Invasion of Duffy-negative Red CellsR01AI097366 · NIAID · CASE WESTERN RESERVE UNIVERSITY · PI ZIMMERMAN, PETER A. · 2013 to 2017
$3.6M
NIAID NIH HHS R01 AI097366Wellcome Trust 200909/Z/16/Z
6 · The paper itself

Abstract

Effective malaria control strategies require an accurate understanding of the epidemiology of locally transmitted Plasmodium species. Compared to Plasmodium falciparum infection, Plasmodium vivax has a lower asexual parasitaemia, forms dormant liver-stages (hypnozoites), and is more transmissible. Hence, treatment and diagnostic policies aimed exclusively at P. falciparum are far less efficient against endemic P. vivax. Within sub-Saharan Africa, malaria control programmes justly focus on reducing the morbidity and mortality associated with P. falciparum. However, the recent emphasis on malaria elimination and increased accessibility of more sensitive diagnostic tools have revealed greater intricacies in malaria epidemiology across the continent. Since 2010, the number of studies identifying P. vivax endemic to Africa has expanded considerably, with 88 new scientific reports published since a review of evidence in 2015, approximately doubling the available data. There is evidence of P. vivax in all regions of Africa, apparent from infected vectors, clinical cases, serological indicators, parasite prevalence, exported infections, and P. vivax-infected Duffy-negative individuals. Where the prevalence of microscopic parasitaemia is low, a greater proportion of P. vivax infections were observed relative to P. falciparum. This evidence highlights an underlying widespread presence of P. vivax across all malaria-endemic regions of Africa, further complicating the current practical understanding of malaria epidemiology in this region. Thus, ultimate elimination of malaria in Africa will require national malaria control programmes to adopt policy and practice aimed at all human species of malaria.

Indexed as

Endemic DiseasesAfricaDuffy Blood-Group SystemHumansMalaria, FalciparumMalaria, VivaxOdds RatioParasitemiaPlasmodium falciparumPlasmodium vivaxPrevalenceDuffy Blood-Group System

Identifiers

PMID30703083
PMCPMC6372205

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.