Plasmodium vivax vs Plasmodium falciparum- 40 Differences

Five species of Plasmodium are believed to cause malaria in humans: Plasmodium vivax, P. falciparum, P. malariae, P .ovale and P. knowlesi

Differences between Plasmodium vivax and Plasmodium falciparum

Of the five species that infect humans, P. vivax and P. falciparum cause 95% of the total infections.

S.N.CharacterPlasmodium vivaxPlasmodium falciparum
1.Disease CausedBenign tertian malariaMalignant tertian malaria
2.Geographic areaTropics, Africa (rare in West Africa), Middle East, Asia, Central and South America. It is the most common geographically widespread species of Plasmodium causing malaria in human beings.Predominant species, worldwide tropics, but especially sub-Saharan Africa.
3.Type of RBC invadedPrimarily invades reticulocytes, young red cells.Invades all red cells regardless of age.
4.Parasitized red cellsEnlarged, pale. Fine stippling (Schüffner dots).Not enlarged. Coarse stippling (Maurer’s clefts).
5.Color of cytoplasm ( in Giemsa stained thin blood smear)Decolorized, pale.Normal, bluish tinge at times.
6.Level of usual maximum parasitemiaUp to 30,000/μL of bloodMay exceed 200,000/μL;

commonly 50,000/μL

7.No. of merozoites released per infected hepatocyte30,00010,000
8.Ring stage


Large rings (1/3–1/2 red cell diameter). Usually one chromatin granule; ring delicate.Small rings (1/5 red cell diameter). Often two granules; multiple infections common; ring delicate, may adhere to red cells.
9.Pigment in developing trophozoitesFine; light brown; scatteredCoarse; black; few clumps
10.Late TrophozoiteMedium Sized
Rarely amoeboid
Vacuole inconspicuous.
Markedly amoeboid

Vacuole prominent.

11.Late trophozoite shapeVery pleomorphicCompact and rounded
12.SchizontSmall, compact,
Single pigmented mass

Seldom seen in the peripheral blood smear

Large, amoeboid,
Pigments coarse

Can be seen in the blood smear

13.Mature schizonts (segmenters)More than 12 merozoites (14–24)Usually more than 12 merozoites (8–32). Very rare in peripheral blood.
14.GametocytesRound or ovalCrescentic
15.MicrogametocytesKidney-shaped with blunt round ends.

Cytoplasm stains pale blue.Nucleus large.Chromatin diffuse.Granules fine, scattered.

Spherical, compact.

Cytoplasm stains pale light blue.Chromatin undivided.Granules abundant.


Cytoplasm stains dark blue.Nucleus compact.Chromatin central.Pigment more compact.

Cytoplasm stains dark blue. Nucleus small.

Pigment diffuse ecoarse.

17.Distribution in peripheral bloodAll formsOnly rings and crescents (gametocytes).
18.Duration of asexual phase in man36-48 hrs

Usually 48 hrs

48 hrs
19.Duration of sporogony in mosquito22-23 days at 20°C

10-12 days at 27°C

30 days at 17.5°C

10 days at 25-30°C

20.Duration of intrahepatic phase5.5 days8 days
21.Duration of Schizogony12 days14 days
22.Mechanism of Attachment and ReceptorMerozoite (non–complement-mediated attachment), Duffy antigenMerozoite and glycophorin A and B
23.Pigment ColorBlack and Dark BrownYellow or Golden Brown
24.Incubation periodIncubation period (usually 10 to 17 days)Shortest of all the plasmodia, ranging from 7 to 10 days, and does not extend for months to years.
25.Signs and SymptomsPatient experiences vague influenza-like symptoms with headache, muscle pains, photophobia, anorexia, nausea, and vomiting.After the early influenza-like symptoms, P. falciparum rapidly produces daily (quotidian) chills and fever as well as severe nausea, vomiting, and diarrhea. The periodicity of the attacks then becomes tertian (36 to 48 hours), and fulminating disease develops.
26.Symptom periodicity48 hr36-48 hr
27.ComplicationsSevere complications are uncommon in P. vivax infections, although coma and sudden death or other symptoms of cerebral involvement have been reported.Cerebral malaria, renal failure, circulatory collapse, severe anemia, hemoglobinuria, abnormal bleeding, acute respiratory distress syndrome, and jaundice. Acute cerebral malaria involves changes in mental status and if untreated may result in fatality within 3 days.
28.AnemiaMild to moderateSevere
29.CNS involvementRareVery common
30.Nephrotic syndromePossibleRare
31.Disease featuresP. vivax causes paroxysms of fever and chills every 48 hours; a spectrum of severe, life threatening syndromes similar to that with P. falciparum may be seen; a liver stage may cause relapses and recrudescences.P. falciparum produces daily (quotidian) chills and fever with nausea, vomiting, diarrhea progressing to tertian (36 to 48 hours) periodicity with fulminating disease (malignant tertian); no persistent liver stage.
32.Severity of infectionComparatively less severe infection.Considered the most pathogenic and “deadliest” of all Plasmodium parasites.
33.Mortality and MorbidityRelatively LowerHigher
34.PrevalenceThe most prevalent of the human plasmodia.Comparatively less prevalent.
35.DiagnosisThick and thin blood smears; ring stage in RBCs with Schüffner dotsThick and thin blood smears; banana-shaped gametocytes; double rings in RBCs
36.Main diagnostic criteriaLarge pale red cell; trophozoite irregular; pigment usually present; Schüffner’s dots not always present; several phases of growth seen in one smear; gametocytes appear as early as third day.Development following ring stage takes place in blood vessels of internal organs; delicate ring forms and crescent shaped gametocytes are only forms normally seen in peripheral blood; gametocytes appear after 7-10 days.
37.TreatmentChloroquine (where no resistance), otherwise mefloquine or atovaquone/ proguanil, either followed by primaquine for relapse.Chloroquine (where no resistance); quinine sulfate plus doxycycline or plus tetracycline or plus clindamycin; atovaquone/ proguanil, mefloquine, bartesunate plus doxycycline or clindamycin; artemether/ lumefantrine (coartem).
38.Duration of untreated infection5-7 years6-17 months
39.RelapseCan relapse due to hypnozoites in liverNo  relapse
40.Summarized distinguishing characteristics1. 48-hour cycle

2. Tends to infect young cells3. Enlarged RBCs4. Schüffner’s dots (true stippling) after 8-10 hours5. Delicate ring6. Very ameboid trophozoite7. Mature schizont contains 12-24 merozoites

1. 36-48-hour cycle

2. Tends to infect any cell regardless of age, thus very heavy infection may result3. All sizes of RBCs4. No Schüffner’s dots (Maurer’s dots: may be larger, single dots, bluish)5. Multiple rings/cell (only young rings, gametocytes, and occasional mature schizonts are seen in peripheral blood)6. Delicate rings, may have two dots of chromatin/ring, appliqué or accolé forms7. Crescent-shaped gametocytes

Interesting Science Videos


  1. Brooks, G. F., Jawetz, E., Melnick, J. L., & Adelberg, E. A. (2010). Jawetz, Melnick, & Adelberg’s medical microbiology. New York: McGraw Hill Medical.
  2. Murray, P. R., Rosenthal, K. S., & Pfaller, M. A. (2013). Medical microbiology. Philadelphia: Elsevier/Saunders.
  3. Tille, Patricia M., author. (2014). Bailey & Scott’s diagnostic microbiology. St. Louis, Missouri :Elsevier

About Author

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Sagar Aryal

Sagar Aryal is a microbiologist and a scientific blogger. He is doing his Ph.D. at the Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal. He was awarded the DAAD Research Grant to conduct part of his Ph.D. research work for two years (2019-2021) at Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS), Saarbrucken, Germany. Sagar is interested in research on actinobacteria, myxobacteria, and natural products. He is the Research Head of the Department of Natural Products, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal. Sagar has more than ten years of experience in blogging, content writing, and SEO. Sagar was awarded the SfAM Communications Award 2015: Professional Communicator Category from the Society for Applied Microbiology (Now: Applied Microbiology International), Cambridge, United Kingdom (UK). Sagar is also the ASM Young Ambassador to Nepal for the American Society for Microbiology since 2023 onwards.

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