Table 4. Comparison of post-treatment vivax incidence rate by risk factor.
Risk present | Risk absent | ||||||||||||
P. vivax relapse | No P. vivax relapse | Incidence rate/1000/30days | P. vivax relapse | No P. vivax relapse | Incidence rate/1000/30days | ||||||||
Risk factor | no. | days of follow-up | no. | days of follow-up | no. | days of follow-up | no. | days of follow-up | Incidence Rate Ratio | 95%CI | p value | ||
Male gender | 50 | 1378 | 125 | 4662 | 248 | 9 | 244 | 59 | 2016 | 119 | 2.08 | 1.01, 4.81 | 0.03 |
History of malaria in previous 12 mos | 32 | 881 | 68 | 2338 | 298 | 27 | 741 | 115 | 4298 | 161 | 1.86 | 1.08, 3.22 | 0.02 |
Duration of symptoms >3 days | 25 | 728 | 55 | 1946 | 280 | 34 | 894 | 129 | 4732 | 181 | 1.55 | 0.88, 2.67 | 0.10 |
Baseline parasitemia (/µl) <10 K | 35 | 937 | 93 | 3248 | 251 | 24 | 685 | 91 | 3430 | 175 | 1.43 | 0.83, 2.52 | 0.17 |
Baseline parasitemia (/µl) >50 K | 3 | 77 | 24 | 952 | 87 | 56 | 1545 | 160 | 5726 | 231 | 0.38 | 0.08, 1.16 | 0.07 |
Fever (T>37.9°C) | 31 | 804 | 104 | 3822 | 201 | 28 | 818 | 80 | 2856 | 229 | 0.88 | 0.51, 1.52 | 0.62 |
Anemia (Hct<30%) | 4 | 133 | 10 | 336 | 256 | 55 | 1489 | 174 | 6324 | 211 | 1.21 | 0.32, 3.29 | 0.67 |
Baseline platelet count <150 K | 14 | 413 | 80 | 3360 | 111 | 10 | 294 | 18 | 756 | 286 | 0.39 | 0.16, 0.98 | 0.03 |
Abnormal ALT (>40 U/L) | 3 | 70 | 19 | 798 | 104 | 24 | 749 | 88 | 3696 | 162 | 0.64 | 0.12, 2.11 | 0.49 |
Gametocytes on admit | 23 | 609 | 20 | 686 | 533 | 36 | 1013 | 164 | 5992 | 154 | 3.46 | 1.96, 5.99 | <0.001 |
Gametocytes on admit by PCR* | 16 | 469 | 13 | 546 | 473 | 11 | 350 | 96 | 4032 | 75 | 6.28 | 2.74, 15.0 | <0.001 |
Gametocytes on day 14 | 14 | 364 | 13 | 420 | 536 | 44 | 1223 | 171 | 6258 | 176 | 3.04 | 1.54, 5.64 | 0.001 |
Gametocytes anytime during follow up | 39 | 1071 | 37 | 1260 | 502 | 20 | 551 | 147 | 5418 | 101 | 4.99 | 2.84, 9.04 | <0.001 |
Parasite clearance time ≥72 hrs | 25 | 707 | 100 | 3766 | 168 | 34 | 915 | 84 | 2912 | 267 | 0.63 | 0.36, 1.09 | 0.08 |
Fever clearance time >24 hrs | 14 | 378 | 74 | 2716 | 136 | 45 | 1244 | 109 | 3934 | 261 | 0.52 | 0.26, 0.97 | 0.03 |
Bioassay positive*,** | 2 | 77 | 6 | 252 | 182 | 25 | 742 | 103 | 4326 | 148 | 1.23 | 0.14, 4.94 | 0.72 |
*Data only available for ARC2 patients (Pv n = 27, no Pv n = 109).
**Antimalarial activity of sera against P. falciparum lab strains in a previously published ex-vivo bioassay, used as a surrogate measure of prior use of antimalarial drugs [15].