On the epidemiology of Plasmodium vivax malaria: past and present with special reference to the former USSR

Presently, many malaria-endemic countries in the world are transitioning towards malaria elimination. Out of the 105 countries with ongoing malaria transmission, 10 countries are classified as being in the pre-elimination phase of malaria control, and 9 countries are in the malaria elimination stage, whereas 7 countries are classified as being in the prevention of introduction phase. Between 2000 and 2015, 17 countries eliminated malaria (i.e., attained zero indigenous cases for 3 years or more). Seven countries were certified by the WHO as having successfully eliminated malaria. The purpose of this review was to analyse the epidemiological characteristics of vivax malaria during the various stages of malaria eradication (elimination) programmes in different countries in the past and present. Experiences of the republics of the former USSR with malaria are interesting, particularly since the data overwhelmingly were published in Russian and might not be known to western readers. Among the most important characteristics of Plasmodium vivax epidemiology at present are changes in the ratio of the short-incubation P. vivax to long-incubation P. vivax, the incidence of severe P. vivax cases, the increased numbers of asymptomatic P. vivax cases, the reduced response to anti-malarials and a few others. Various factors contributing towards the peculiarities of P. vivax epidemiology are discussed.