Towards one standard treatment for uncomplicated Plasmodium falciparum and Plasmodium vivax malaria: perspectives from and for the peruvian amazon

Malaria continues to wreak havoc in Peruvian Amazonia. Long efforts of research have brought important lessons on its peculiar epidemiology: the heterogeneous levels of transmission, a large reservoir of both asymptomatic and submicroscopic infections; the co-transmission of Plasmodium vivax and Plasmodium falciparum in the same areas; as well the limitations of current diagnostics. With these features, national elimination program could largely benefit from simplified standard treatment, with the use of artemisinine based Combination therapy (ACT) and an even shorter schemes of primaquine to be tested. We acknowledge some uncertainty of true glucose-6-phosphate dehydrogenase deficiency (G6PD) prevalence and genetic polymorphisms related cytochrome P-450 isozyme 2D6 functioning. Once we have a better understanding, tafenoquine (TQ) whether or not in combination with a rapid G6PD enzyme test, may become future pathway to eliminate the otherwise hidden reservoir of the P. vivax hypnozoite by one standard Plasmodium treatment.