Inclusion of gametocyte parameters in anti‑malarial drug efficacy studies: filling a neglected gap needed for malaria elimination

Rashad Abdul‑ghani (1, 2) , Leonardo K. Basco (3) , John C. Beier (4) , Mohammed A. K. Mahdy (1, 2)

1 Department of Parasitology
2 Tropical Disease Research Center
3 URMITE - Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes
4 Department of Public Health Sciences

Standard anti‑malarial drug efficacy and drug resistance assessments neglect the gametocyte parameters in their pro‑ tocols. With the spread of drug resistance and the absence of clinically proven vaccines, the use of gametocytocidal drugs or drug combinations with transmission‑blocking activity is a high priority for malaria control and elimination. However, the limited repertoire of gametocytocidal drugs and induction of gametocytogenesis after treatment with certain anti‑malarial drugs necessitate both regular monitoring of gametocytocidal activities of anti‑malarial drugs in clinical use and the effectiveness of candidate gametocytocidal agents. Therefore, updating current protocols of anti‑ malarial drug efficacy is needed to reflect the effects of anti‑malarial drugs or drug combinations on gametocyte car‑ riage and gametocyte density along with asexual parasite density. Developing protocols of anti‑malarial drug efficacy that include gametocyte parameters related to both microscopic and submicroscopic gametocytaemias is important if drugs or drug combinations are to be strategically used in transmission‑blocking interventions in the context of malaria elimination. The present piece of opinion highlights the challenges in gametocyte detection and follow‑up and discuss the need for including the gametocyte parameter in anti‑malarial efficacy studies.

Mots clés: Plasmodium; Gametocyte; Anti‑malarial drug; Drug resistance; Efficacy study; Malaria elimination

Domaines: Santé publique et épidémiologie

Rashad Abdul‑ghani, Leonardo K. Basco, John C. Beier, Mohammed A. K. Mahdy. Inclusion of gametocyte parameters in anti‑malarial drug efficacy studies: filling a neglected gap needed for malaria elimination. Malaria Journal, 2015, 14 (413), ⟨10.1186/s12936‑015‑0936‑4⟩. ⟨hal-01236053⟩