{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T14:39:59Z","timestamp":1778769599222,"version":"3.51.4"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004156","name":"Mahidol University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004156","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Countries in the Greater Mekong sub-region (GMS) have been encouraged to deploy mass chloroquine treatments given monthly for four months to reduce the burden of vivax malaria. This paper summarizes briefly current knowledge on <jats:italic>Plasmodium vivax<\/jats:italic> epidemiology, the biology of vivax relapse and previous experience using dihydroartemisinin\u2013piperaquine mass treatments in the GMS to show why this approach would be extremely cost-ineffective. Around 800 full treatment courses in 200 people would be needed to prevent one symptomatic case. Mass chloroquine treatment will contribute little or nothing to the elimination of vivax malaria in this area.<\/jats:p>","DOI":"10.1186\/s12936-025-05399-2","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T10:44:51Z","timestamp":1748256291000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does mass chloroquine treatment have any role in the elimination of Plasmodium vivax ?"],"prefix":"10.1186","volume":"24","author":[{"given":"Nicholas J.","family":"White","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somya","family":"Mehra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Watson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"5399_CR1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/1475-2875-13-51","volume":"13","author":"A Kondrashin","year":"2014","unstructured":"Kondrashin A, Baranova AM, Ashley EA, Recht J, White NJ, Sergiev VP. Mass primaquine treatment to eliminate vivax malaria: lessons from the past. Malar J. 2014;13:51.","journal-title":"Malar J"},{"issue":"1","key":"5399_CR2","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1186\/1475-2875-10-297","volume":"10","author":"NJ White","year":"2011","unstructured":"White NJ. Determinants of relapse periodicity in Plasmodium vivax malaria. Malar J. 2011;10(1):297.","journal-title":"Malar J"},{"issue":"4","key":"5399_CR3","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1093\/trstmh\/trz002","volume":"113","author":"NJ White","year":"2019","unstructured":"White NJ. The rise and fall of long-latency Plasmodium vivax. Trans R Soc Trop Med Hyg. 2019;113(4):163\u20138.","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"2","key":"5399_CR4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pmed.1002745","volume":"16","author":"L von Seidlein","year":"2019","unstructured":"von Seidlein L, Peto TJ, Landier J, Nguyen TN, Tripura R, Phommasone K, et al. The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: a cluster randomised trial. PLoS Med. 2019;16(2):1\u201326.","journal-title":"PLoS Med"},{"issue":"10133","key":"5399_CR5","doi-asserted-by":"publisher","first-page":"1916","DOI":"10.1016\/S0140-6736(18)30792-X","volume":"391","author":"J Landier","year":"2018","unstructured":"Landier J, Parker DM, Thu AM, Lwin KM, Delmas G, Nosten FH, et al. Effect of generalised access to early diagnosis and treatment and targeted mass drug administration on Plasmodium falciparum malaria in Eastern Myanmar: an observational study of a regional elimination programme. Lancet. 2018;391(10133):1916\u201326.","journal-title":"Lancet"},{"issue":"11","key":"5399_CR6","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1016\/S1473-3099(20)30997-X","volume":"21","author":"ARD McLean","year":"2021","unstructured":"McLean ARD, Indrasuta C, Khant ZS, Phyo AK, Maung SM, Heaton J, et al. Mass drug administration for the acceleration of malaria elimination in a region of Myanmar with artemisinin-resistant falciparum malaria: a cluster-randomised trial. Lancet Infect Dis. 2021;21(11):1579\u201389.","journal-title":"Lancet Infect Dis"},{"key":"5399_CR7","unstructured":"Mekong Malaria Elimination Programme. Workshop on malaria surveillance and malaria elimination in the Greater Mekong Subregion, Siem Reap, Cambodia, 15\u201317 November 2023. World Health Organisation; 2024."},{"issue":"10","key":"5399_CR8","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1016\/S1473-3099(14)70855-2","volume":"14","author":"R Price","year":"2014","unstructured":"Price R, von Seidlein L, Valecha N, Nosten F, Baird JK, White NJ. Global extent of chloroquine-resistant Plasmodium vivax\u202f: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14(10):982\u201391.","journal-title":"Lancet Infect Dis"},{"issue":"10","key":"5399_CR9","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1093\/cid\/ciy319","volume":"67","author":"CS Chu","year":"2018","unstructured":"Chu CS, Phyo AP, Lwin KM, Win HH, San T, Aung AA, et al. Comparison of the cumulative efficacy and safety of chloroquine, artesunate, and chloroquine-primaquine in Plasmodium vivax malaria. Clin Infect Dis. 2018;67(10):1543\u20139.","journal-title":"Clin Infect Dis"},{"issue":"2","key":"5399_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0228190","volume":"15","author":"K Phommasone","year":"2020","unstructured":"Phommasone K, van Leth F, Peto TJ, Landier J, Nguyen TN, Tripura R, et al. Mass drug administrations with dihydroartemisinin\u2013piperaquine and single low dose primaquine to eliminate Plasmodium falciparum have only a transient impact on Plasmodium vivax\u202f: findings from randomised controlled trials. PLoS ONE. 2020;15(2):1\u201316.","journal-title":"PLoS ONE"},{"issue":"9","key":"5399_CR11","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1093\/infdis\/jiy686","volume":"219","author":"V Chaumeau","year":"2018","unstructured":"Chaumeau V, Kajeechiwa L, Fustec B, Landier J, Naw Nyo S, Nay Hsel S, et al. Contribution of asymptomatic Plasmodium infections to the transmission of malaria in Kayin State, Myanmar. J Infect Dis. 2018;219(9):1499\u2013509.","journal-title":"J Infect Dis"},{"key":"5399_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtbi.2022.111014","volume":"537","author":"S Mehra","year":"2022","unstructured":"Mehra S, Stadler E, Khoury D, McCaw JM, Flegg JA. Hypnozoite dynamics for Plasmodium vivax malaria: the epidemiological effects of radical cure. J Theor Biol. 2022;537: 111014.","journal-title":"J Theor Biol"},{"key":"5399_CR13","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.04692","volume":"3","author":"MT White","year":"2014","unstructured":"White MT, Karl S, Battle KE, Hay SI, Mueller I, Ghani AC. Modelling the contribution of the hypnozoite reservoir to Plasmodium vivax transmission. Elife. 2014;3: e04692.","journal-title":"Elife"},{"issue":"9029","key":"5399_CR14","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1016\/S0140-6736(96)04465-0","volume":"348","author":"F Nosten","year":"1996","unstructured":"Nosten F, Luxemburger C, Kyle DE, Ballou WR, Wittes J, Wah E, et al. Randomised double-blind placebo-controlled trial of SPf66 malaria vaccine in children in northwestern Thailand, Shoklo SPf66 Malaria Vaccine Trial Group. Lancet. 1996;348(9029):701\u20137.","journal-title":"Lancet"},{"issue":"51","key":"5399_CR15","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2401024121","volume":"121","author":"S Mehra","year":"2024","unstructured":"Mehra S, Nosten F, Luxemburger C, White NJ, Watson JA. Modeling the within host dynamics of Plasmodium vivax hypnozoite activation: an analysis of the SPf66 vaccine trial. Proc Natl Acad Sci USA. 2024;121(51): e2401024121.","journal-title":"Proc Natl Acad Sci USA"},{"issue":"7","key":"5399_CR16","doi-asserted-by":"publisher","first-page":"e02476","DOI":"10.1128\/AAC.02476-17","volume":"62","author":"J Watson","year":"2018","unstructured":"Watson J, Chu CS, Tarning J, White NJ. Characterizing blood-stage anti-malarial drug MIC values in vivo using reinfection patterns. Antimicrob Agents Chemother. 2018;62(7):e02476-e2517.","journal-title":"Antimicrob Agents Chemother"},{"issue":"6","key":"5399_CR17","first-page":"277","volume":"89","author":"J Verdrager","year":"1986","unstructured":"Verdrager J. Epidemiology of the emergence and spread of drug-resistant falciparum malaria in South-East Asia and Australasia. J Trop Med Hyg. 1986;89(6):277\u201389.","journal-title":"J Trop Med Hyg"},{"key":"5399_CR18","unstructured":"World Health Organization Mekong Malaria Elimination Programme, Epidemiology summary January 2024. 2024;49:1\u20139."}],"container-title":["Malaria Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-025-05399-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12936-025-05399-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-025-05399-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T10:44:53Z","timestamp":1748256293000},"score":1,"resource":{"primary":{"URL":"https:\/\/malariajournal.biomedcentral.com\/articles\/10.1186\/s12936-025-05399-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5399"],"URL":"https:\/\/doi.org\/10.1186\/s12936-025-05399-2","relation":{},"ISSN":["1475-2875"],"issn-type":[{"value":"1475-2875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,26]]},"assertion":[{"value":"21 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not relevant.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not relevant.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"166"}}