A Comparative Analysis of the Pathogenesis of Plasmodium vivax and Plasmodium falciparum: A Literature Review

A Comparative Analysis of the Pathogenesis of Plasmodium vivax and Plasmodium falciparum: A Literature Review

Authors

  • Anak Agung Ngurah Ardha Dwikananda Biomedical Science Magister Program, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
  • Dewa Ayu Agus Sri Laksemi Departement of Parasitology, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
  • Putu Ayu Asri Damayanti Departement of Parasitology, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia

Keywords:

Pathogenesis, Plasmodium vivax, Plasmodium falciparum

Abstract

Background: Malaria is one of the significant health problems faced in the world with Plasmodium falciparum and Plasmodium vivax being the major two types of malaria in humans. Humans have long been exposed to plasmodium falciparum, which causes severe disease with dangerous complications, compared to plasmodium vivax, which was identified as causing a less severe, relapsing infection. But recent data casts doubt on this dichotomy since there is the possibility of P. vivax causing severe, and even fatal forms of malaria.

Objective: The objective of this review is to compare the pathogenic processes of Plasmodium falciparum and Plasmodium vivax systematically in terms of molecular, cellular interactions, host immunity aspects with the associated clinical presentation and morbidities.

Methods: Search of the literature was carried at PubMed, Scopus, and Google Scholar databases with the use of pathogenesis, clinical characteristic and complications of both species to be compared.

Results: Literature synthesis indicates that there are unique pathogenic profiles. Major dissimilarities were established in path of erythrocyte invasion, accomplishment of cytoadherence and sequestration, alteration of the host cell, and potential biomass of the parasite. The pathogenesis of the Plasmodium falciparum generally involves microvascular obstruction due to sequestration whereas the pathology of Plasmodium vivax seems more to do with the excessive inflammatory status, severe anaemia and complications of the parasite unique life cycle stages that have evolved as hypnozoites.

Conclusion: The causes of infections are different, but both species are serious pathogens that can bring serious illnesses. An in-depth consideration of their specific and symbiotic virulence mechanisms is extremely important in making progress in clinical practice, diagnostics, and creation of new customized therapies and prophylaxis.

References

Adapa, S. R., Taylor, R. A., Wang, C., Thomson-Luque, R., Johnson, L. R., & Jiang, R. H. (2019). Plasmodium vivax readiness to transmit: implication for malaria eradication. BMC Systems Biology, 13(1), 5.

Alfaki, D. A., Hussein, M., Hassan, M., Eloraish, A. G., & Elbasheir, M. M. (2023). Inflammatory immune mediators and Plasmodium falciparum infection: A cross-sectional study among Sudanese patients with severe and uncomplicated malaria. Exploration of Immunology, 3(4), 406-415.

Ammar, A. I., El-Hefnawy, S. M., Shehab-Eldeen, S., Essa, A., ELnaidany, S. S., Mostafa, R. G., Alsalman, M. H., & El-Refai, S. A. (2022). Plasmodium falciparum malaria susceptibility and severity: influence of MyD88-adaptor-like gene (rs8177374) polymorphism. Infection and Drug Resistance, 6815-6827

Amoah, L. E., Acquah, F. K., Nyarko, P. B., Cudjoe, E., Donu, D., Ayanful-Torgby, R., & Awandare, G. A. (2020). Comparative analysis of asexual and sexual stage Plasmodium falciparum development in different red blood cell types. Malaria journal, 19(1), 200.

Bannister, L. H., Dluzewski, A. R., Meyer, E. V., Lapp, S. A., & Galinski, M. R. (2025). Caveola-vesicle complexes of Plasmodium vivax and Plasmodium cynomolgi: large-scale aggregation and structure of PHIST-positive vesicles in late schizont-infected red blood cells. Malaria Journal, 24(1), 226.

Barber, B. E., Grigg, M. J., Piera, K., Amante, F. H., William, T., Boyle, M. J., & Anstey, N. M. (2019). Antiphosphatidylserine immunoglobulin M and immunoglobulin G antibodies are higher in vivax than falciparum malaria, and associated with early anemia in both species. The Journal of infectious diseases, 220(9), 1435-1443.

Baro, B., Kim, C. Y., Lin, C., Kongsomboonvech, A. K., Tetard, M., Peterson, N. A., & Egan, E. S. (2023). Plasmodium falciparum exploits CD44 as a coreceptor for erythrocyte invasion. Blood, 142(23), 2016-2028.

Battle, K. E., Lucas, T. C., Nguyen, M., Howes, R. E., Nandi, A. K., Twohig, K. A., & Gething, P. W. (2019). Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000–17: a spatial and temporal modelling study. The Lancet, 394(10195), 332-343.

Dombrowski, J. G., Barateiro, A., Peixoto, E. P. M., Barros, A. B. C. D. S., Souza, R. M. D., Clark, T. G., & Marinho, C. R. F. (2021). Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon. PLoS neglected tropical diseases, 15(4), e0009390.

Fernandez-Becerra, C., Bernabeu, M., Castellanos, A., Correa, B. R., Obadia, T., Ramirez, M., & Del Portillo, H. A. (2020). Plasmodium vivax spleen-dependent genes encode antigens associated with cytoadhesion and clinical protection. Proceedings of the National Academy of Sciences, 117(23), 13056-13065.

Ferro,C., Rincón-Acevedo, C.Y., Olivera, M. J., Walteros, D.M., & Prieto, F. (2025). Clinical and epidemiological characteristics of complicated malaria in Colombia, 2019. The Microbe, Volume 6, 2025, 100265

Graca, L., Abreu, I. G., Santos, A. S., Graca, L., Dias, P. F., & Santos, M. L. (2020). Descriptive Acute Respiratory Distress Syndrome (ARDS) in adults with imported severe Plasmodium falciparum malaria: A 10 year-study in a Portuguese tertiary care hospital. PLoS One, 15(7), e0235437.

Kamau, E., Bennett, J. W., & Yadava, A. (2022). Safety and Tolerability of Mosquito Bite-Induced Controlled Human Infection with Plasmodium vivax in Malaria-Naive Study Participants—Clinical Profile and Utility of Molecular Diagnostic Methods. The Journal of Infectious Diseases, 225(1), 146-156.

Kanjee, U., Grüring, C., Babar, P., Meyers, A., Dash, R., Pereira, L., Mascarenhas, A., Chaand, M., Rangel, G. W., Clark, M. A., Chery, L., Gomes, E., Rathod, P, K., & Duraisingh, M. T. (2021). Plasmodium vivax strains use alternative pathways for invasion. The Journal of Infectious Diseases, 223(10), 1817-1821.

Khan, M. A., Singh, D., Bajaj, K., Kumar, S., Jamal, A., Kashyap, V., & Kohli, S. (2023). Renal Complications of Benign Tertian Malaria: A Case-control Study from South Delhi, India. Journal of Clinical & Diagnostic Research, 17(7).

Leitgeb, A. M., Charunwatthana, P., Rueangveerayut, R., Uthaisin, C., Silamut, K., Chotivanich, K.,& Dondorp, A. M. (2017). Inhibition of merozoite invasion and transient de-sequestration by sevuparin in humans with Plasmodium falciparum malaria. PLoS One, 12(12), e0188754.

Leopold, S. J., Watson, J. A., Jeeyapant, A., Simpson, J. A., Phu, N. H., Hien, T. T., & White, N. J. (2019). Investigating causal pathways in severe falciparum malaria: A pooled retrospective analysis of clinical studies. PLoS medicine, 16(8), e1002858.

Looker, O., Blanch, A. J., Liu, B., Nunez-Iglesias, J., McMillan, P. J., Tilley, L., & Dixon, M. W. (2019). The knob protein KAHRP assembles into a ring-shaped structure that underpins virulence complex assembly. PLoS pathogens, 15(5), e1007761.

Matlani, M., Kojom, L. P., Mishra, N., Dogra, V., & Singh, V. (2020). Severe vivax malaria trends in the last two years: a study from a tertiary care centre, Delhi, India. Annals of Clinical Microbiology and Antimicrobials, 19(1), 49.

Mohanty, S., Sahu, P. K., Pattnaik, R., Majhi, M., Maharana, S., Bage, J., & Wassmer, S. C. (2022). Evidence of brain alterations in noncerebral falciparum malaria. Clinical Infectious Diseases, 75(1), 11-18.

Namazzi, R., Opoka, R., Datta, D., Bangirana, P., Batte, A., Berrens, Z., & John, C. C. (2022). Acute kidney injury interacts with coma, acidosis, and impaired perfusion to significantly increase risk of death in children with severe malaria. Clinical Infectious Diseases, 75(9), 1511-1519.

Ovchynnikova, E., Aglialoro, F., Bentlage, A. E., Vidarsson, G., Salinas, N. D., von Lindern, M., & van den Akker, E. (2017). DARC extracellular domain remodeling in maturating reticulocytes explains Plasmodium vivax tropism. Blood, The Journal of the American Society of Hematology, 130(12), 1441-1444.

Padilla-Rodríguez, J. C., Olivera, M. J., & Guevara-García, B. D. (2020). Parasite density in severe malaria in Colombia. PLoS One, 15(6), e0235119.

Punnath, K., Dayanand, K. K., Chandrashekar, V. N., Achur, R. N., Kakkilaya, S. B., Ghosh, S. K., & Gowda, D. C. (2019). Association between Inflammatory Cytokine Levels and Thrombocytopenia during Plasmodium falciparum and P. vivax Infections in South‐Western Coastal Region of India. Malaria research and treatment, 2019(1), 4296523.

Shaikh, R., Ghosh, K., & Gorakshakar, A. (2025). Plasmodium vivax Infections in Duffy-Negative Individuals: A Paradigm Shift in Indian Malaria Epidemiology. Mediterranean Journal of Hematology and Infectious Diseases, 17(1), e2025044.

World Health Organization (WHO). (2024). World malaria report 2024. Geneva: World Health Organization. Available at: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2024

Yahata, K., Hart, M. N., Davies, H., Asada, M., Wassmer, S. C., Templeton, T. J., & Kaneko, O. (2021). Gliding motility of Plasmodium merozoites. Proceedings of the National Academy of Sciences, 118(48), e2114442118.

Yang, A. S., Dutta, D., Kretzschmar, K., Hendriks, D., Puschhof, J., Hu, H., & Sauerwein, R. W. (2023). Development of Plasmodium falciparum liver-stages in hepatocytes derived from human fetal liver organoid cultures. Nature Communications, 14(1), 4631.

Downloads

Published

2025-08-14

How to Cite

A Comparative Analysis of the Pathogenesis of Plasmodium vivax and Plasmodium falciparum: A Literature Review (Anak Agung Ngurah Ardha Dwikananda, Dewa Ayu Agus Sri Laksemi, & Putu Ayu Asri Damayanti , Trans.). (2025). The Indonesian Journal of General Medicine, 15(1), 29-46. https://doi.org/10.70070/7kjc1h37