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Kearney EA, Amratia P, Kang SY, Agius PA, Alene KA, O’Flaherty K, Oo WH, Cutts JC, Htike W, Da Silva Goncalves D, Razook Z, Barry AE, Drew D, Thi A, Aung KZ, Thu HK, Thein MM, Zaw NN, Htay WYM, Soe AP, Beeson JG, Simpson JA, Gething PW, Cameron E, Fowkes FJI. Geospatial joint modeling of vector and parasite serology to microstratify malaria transmission. Proc Natl Acad Sci U S A 2024; 121:e2320898121. [PMID: 38833464 PMCID: PMC11181033 DOI: 10.1073/pnas.2320898121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/30/2024] [Indexed: 06/06/2024] Open
Abstract
The World Health Organization identifies a strong surveillance system for malaria and its mosquito vector as an essential pillar of the malaria elimination agenda. Anopheles salivary antibodies are emerging biomarkers of exposure to mosquito bites that potentially overcome sensitivity and logistical constraints of traditional entomological surveys. Using samples collected by a village health volunteer network in 104 villages in Southeast Myanmar during routine surveillance, the present study employs a Bayesian geostatistical modeling framework, incorporating climatic and environmental variables together with Anopheles salivary antigen serology, to generate spatially continuous predictive maps of Anopheles biting exposure. Our maps quantify fine-scale spatial and temporal heterogeneity in Anopheles salivary antibody seroprevalence (ranging from 9 to 99%) that serves as a proxy of exposure to Anopheles bites and advances current static maps of only Anopheles occurrence. We also developed an innovative framework to perform surveillance of malaria transmission. By incorporating antibodies against the vector and the transmissible form of malaria (sporozoite) in a joint Bayesian geostatistical model, we predict several foci of ongoing transmission. In our study, we demonstrate that antibodies specific for Anopheles salivary and sporozoite antigens are a logistically feasible metric with which to quantify and characterize heterogeneity in exposure to vector bites and malaria transmission. These approaches could readily be scaled up into existing village health volunteer surveillance networks to identify foci of residual malaria transmission, which could be targeted with supplementary interventions to accelerate progress toward elimination.
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Affiliation(s)
- Ellen A. Kearney
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC3010, Australia
| | - Punam Amratia
- Malaria Atlas Project, Telethon Kids Institute, Perth, WA6009, Australia
| | - Su Yun Kang
- Malaria Atlas Project, Telethon Kids Institute, Perth, WA6009, Australia
| | - Paul A. Agius
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC3010, Australia
- Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, VIC3125, Australia
| | - Kefyalew Addis Alene
- Malaria Atlas Project, Telethon Kids Institute, Perth, WA6009, Australia
- Faculty of Health Sciences, Curtin University, Perth, WA6102, Australia
| | | | - Win Han Oo
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | - Julia C. Cutts
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
- Department of Medicine at the Doherty Institute, The University of Melbourne, Melbourne, VIC3000, Australia
| | - Win Htike
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | | | - Zahra Razook
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
- Institute for Physical and Mental Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC3216, Australia
| | - Alyssa E. Barry
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
- Institute for Physical and Mental Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC3216, Australia
| | - Damien Drew
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
| | - Aung Thi
- Department of Public Health, Myanmar Ministry of Health and Sports, Nay Pyi Taw15011, Myanmar
| | - Kyaw Zayar Aung
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | - Htin Kyaw Thu
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | - Myat Mon Thein
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | - Nyi Nyi Zaw
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | - Wai Yan Min Htay
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | - Aung Paing Soe
- Health Security and Malaria Program, Burnet Institute Myanmar, Yangon11201, Myanmar
| | - James G. Beeson
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
- Department of Infectious Diseases, The University of Melbourne, Melbourne, VIC3000, Australia
- Department of Microbiology, Monash University, Melbourne, VIC3800, Australia
- Central Clinical School, Monash University, Melbourne, VIC3004, Australia
| | - Julie A. Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC3010, Australia
| | - Peter W. Gething
- Malaria Atlas Project, Telethon Kids Institute, Perth, WA6009, Australia
- Faculty of Health Sciences, Curtin University, Perth, WA6102, Australia
| | - Ewan Cameron
- Malaria Atlas Project, Telethon Kids Institute, Perth, WA6009, Australia
- Faculty of Health Sciences, Curtin University, Perth, WA6102, Australia
| | - Freya J. I. Fowkes
- Disease Elimination Program, Burnet Institute, Melbourne, VIC3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC3010, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC3004, Australia
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Forconi CS, Nixon C, Wu HW, Odwar B, Pond-Tor S, Ong'echa JM, Kurtis J, Moormann AM. T follicular helper cell profiles differ by malaria antigen and for children compared to adults. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.13.589352. [PMID: 38659768 PMCID: PMC11042194 DOI: 10.1101/2024.04.13.589352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Circulating T-follicular helper (cT FH ) cells have the potential to provide an additional correlate of protection against Plasmodium falciparum ( Pf) as they are essential to promote B cell production of long-lasting antibodies. Assessing the specificity of cT FH subsets to individual malaria antigens is vital to understanding the variation observed in antibody responses and identifying promising malaria vaccine candidates. Methods Using spectral flow cytometry and unbiased clustering analysis we assessed antigen-specific cT FH cell recall responses in vitro to malaria vaccine candidates Pf SEA-1A and Pf GARP within a cross-section of children and adults living in a malaria holoendemic region of western Kenya. Findings In children, a broad array of cT FH subsets (defined by cytokine and transcription factor expression) were reactive to both malaria antigens, Pf SEA-1A and Pf GARP, while adults had a narrow profile centering on cT FH 17- and cT FH 1/17-like subsets following stimulation with Pf GARP only. Interpretation Because T FH 17 cells are involved in the maintenance of memory antibody responses within the context of parasitic infections, our results suggest that Pf GARP might generate longer lived antibody responses compared to Pf SEA-1A. These findings have intriguing implications for evaluating malaria vaccine candidates as they highlight the importance of including cT FH profiles when assessing interdependent correlates of protective immunity.
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Aung PP, Han KT, Groot W, Biesma R, Thein ZW, Htay T, Lin Z, Aye KH, Adams M, Pavlova M. Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study. Trop Med Health 2024; 52:22. [PMID: 38459581 PMCID: PMC10921590 DOI: 10.1186/s41182-024-00577-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/05/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection. METHODS A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis. RESULTS The prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman's age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy. CONCLUSIONS A comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.
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Affiliation(s)
- Poe Poe Aung
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
- Malaria Consortium, Bangkok, Thailand.
| | - Kay Thwe Han
- Department of Medical Research, Ministry of Health, Yangon, Myanmar
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Regien Biesma
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Zaw Win Thein
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Thura Htay
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Zaw Lin
- National Malaria Control Program, Ministry of Health, Mandalay, Myanmar
| | - Kyin Hla Aye
- Department of Medical Research, Ministry of Health, Yangon, Myanmar
| | - Matthew Adams
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Zhang Y, Ke L, Sun T, Liu Y, Wei B, Du M. Rapid Detection of Malaria Based on Hairpin-Mediated Amplification and Lateral Flow Detection. MICROMACHINES 2023; 14:1917. [PMID: 37893354 PMCID: PMC10609466 DOI: 10.3390/mi14101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Malaria is listed as one of the three most hazardous infectious diseases worldwide. Travelers and migrants passing through exit and entry ports are important sources of malaria pandemics globally. Developing accurate and rapid detection technology for malaria is important. Here, a novel hairpin-mediated amplification (HMA) technique was proposed for the detection of four Plasmodium species, including P. falciparum, P. vivax, P. malariae, and P. ovale. Based on the conserved nucleotide sequence of Plasmodium, specific primers and probes were designed for the HMA process, and the amplicon can be detected using lateral flow detection (LFD); the results can be read visually without specialized equipment. The specificity of HMA-LFD was evaluated using nucleic acids extracted from four different Plasmodium species and two virus species. The sensitivity of HMA-LFD was valued using 10× serial dilutions of plasmid containing the template sequence. Moreover, 78 blood samples were collected to compare HMA-LFD and qPCR. The HMA-LFD results were all positive for four different Plasmodium species and negative for the other two virus species. The sensitivity of HMA-LFD was tested to be near five copies/μL. The analysis of clinical samples indicated that the consistency of HMA-LFD and qPCR was approximately 96.15%. Based on these results, the HMA-LFD assay was demonstrated to be a rapid, sensitive, and specific technique for the detection of Plasmodium and has great advantages for on-site detection in low-resource areas and exit and entry ports.
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Affiliation(s)
- Yang Zhang
- Comprehensive Technical Service Center of Xuzhou Customs, Xuzhou Customs, Xuzhou 221000, China;
| | - Lihui Ke
- Department of Thoracic Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;
| | - Tao Sun
- Nanjing Customs, Nanjing 210001, China;
| | - Yang Liu
- Department of Health and Quarantine, Nanjing Customs, Nanjing 210001, China;
| | - Bo Wei
- Department of Thoracic Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;
| | - Minghua Du
- Department of Emergency, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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Htike W, Oo WH, Lynn T, Sovanda L, Agius PA, Oo MC, Galau NH, Thu KM, Zaw AK, Htwe EP, Cutts JC, Kearney EA, Scott N, O’Flaherty K, Wang B, Khamlome B, Vilay P, Siv S, Fowkes FJI. Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial. BMC Infect Dis 2022; 22:747. [PMID: 36153501 PMCID: PMC9509546 DOI: 10.1186/s12879-022-07724-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting insecticidal nets do not prevent all infectious bites in these high-risk populations. Evidence for the effectiveness of a personal protection package tailored to forest-going MMPs which is acceptable, feasible, and cost-effective for reducing malaria transmission is required to inform the malaria elimination toolkit in the region. Methods A personal protection package consisting of long-lasting insecticidal hammock net, insect repellent and health communication pamphlet was developed in consultation with relevant implementing partners from Cambodia and Lao PDR. An open stepped-wedge cluster-randomised controlled trial will be conducted over a period of 12 months in a minimum of 488 villages (~ 428 in Lao PDR and ~ 60 in Cambodia) to evaluate the effectiveness of the personal protection package. Villages will be randomised into 11 blocks, with blocks transitioned in random order from control to intervention states at monthly intervals, following a 1-month baseline period. The primary outcome of the trial is the prevalence of Plasmodium spp. infection diagnosed by rapid diagnostic test. Difference in prevalence of malaria infection will be estimated across intervention and control periods using generalized linear mixed modelling. Nested within the stepped-wedge cluster-randomised controlled trial is a mixed-methods study to explore the acceptability of the personal protection package, feasibility of implementing a personal protection package as a vector control intervention, and knowledge, attitude and practice of MMPs regarding malaria prevention; and cost-analysis to determine the cost-effectiveness of implementing a personal protection package. Discussion This study, using a rigorous design and mixed-methods methodology, will evaluate whether a personal protection package can reduce residual malaria transmission among forest-going MMPs in Cambodia and Lao PDR. It will also measure implementation research outcomes such as effectiveness of the intervention package, cost-effectiveness, acceptability, and feasibility, in order to inform potential national and regional policy. Trial registration This trial was prospectively registered on ClinicalTrials.gov (NCT05117567) on 11th November 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07724-5.
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O'Flaherty K, Roe M, Fowkes FJ. The role of naturally acquired antimalarial antibodies in subclinical
Plasmodium
spp. infection. J Leukoc Biol 2022; 111:1097-1105. [PMID: 35060185 PMCID: PMC9303632 DOI: 10.1002/jlb.5mr1021-537r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/09/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Katherine O'Flaherty
- Disease Elimination Program Burnet Institute for Medical Research and Public Health Melbourne Australia
| | - Merryn Roe
- Disease Elimination Program Burnet Institute for Medical Research and Public Health Melbourne Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Australia
| | - Freya J.I. Fowkes
- Disease Elimination Program Burnet Institute for Medical Research and Public Health Melbourne Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Australia
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, The University of Melbourne Melbourne Australia
- Department of Infectious Disease Monash University Melbourne Australia
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Ochwedo KO, Omondi CJ, Magomere EO, Olumeh JO, Debrah I, Onyango SA, Orondo PW, Ondeto BM, Atieli HE, Ogolla SO, Githure J, Otieno ACA, Githeko AK, Kazura JW, Mukabana WR, Guiyan Y. Hyper-prevalence of submicroscopic Plasmodium falciparum infections in a rural area of western Kenya with declining malaria cases. Malar J 2021; 20:472. [PMID: 34930283 PMCID: PMC8685826 DOI: 10.1186/s12936-021-04012-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The gold standard for diagnosing Plasmodium falciparum infection is microscopic examination of Giemsa-stained peripheral blood smears. The effectiveness of this procedure for infection surveillance and malaria control may be limited by a relatively high parasitaemia detection threshold. Persons with microscopically undetectable infections may go untreated, contributing to ongoing transmission to mosquito vectors. The purpose of this study was to determine the magnitude and determinants of undiagnosed submicroscopic P. falciparum infections in a rural area of western Kenya. METHODS A health facility-based survey was conducted, and 367 patients seeking treatment for symptoms consistent with uncomplicated malaria in Homa Bay County were enrolled. The frequency of submicroscopic P. falciparum infection was measured by comparing the prevalence of infection based on light microscopic inspection of thick blood smears versus real-time polymerase chain reaction (RT-PCR) targeting P. falciparum 18S rRNA gene. Long-lasting insecticidal net (LLIN) use, participation in nocturnal outdoor activities, and gender were considered as potential determinants of submicroscopic infections. RESULTS Microscopic inspection of blood smears was positive for asexual P. falciparum parasites in 14.7% (54/367) of cases. All of these samples were confirmed by RT-PCR. 35.8% (112/313) of blood smear negative cases were positive by RT-PCR, i.e., submicroscopic infection, resulting in an overall prevalence by RT-PCR alone of 45.2% compared to 14.7% for blood smear alone. Females had a higher prevalence of submicroscopic infections (35.6% or 72 out of 202 individuals, 95% CI 28.9-42.3) compared to males (24.2%, 40 of 165 individuals, 95% CI 17.6-30.8). The risk of submicroscopic infections in LLIN users was about half that of non-LLIN users (OR = 0.59). There was no difference in the prevalence of submicroscopic infections of study participants who were active in nocturnal outdoor activities versus those who were not active (OR = 0.91). Patients who participated in nocturnal outdoor activities and use LLINs while indoors had a slightly higher risk of submicroscopic infection than those who did not use LLINs (OR = 1.48). CONCLUSION Microscopic inspection of blood smears from persons with malaria symptoms for asexual stage P. falciparum should be supplemented by more sensitive diagnostic tests in order to reduce ongoing transmission of P. falciparum parasites to local mosquito vectors.
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Affiliation(s)
- Kevin O. Ochwedo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Collince J. Omondi
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Edwin O. Magomere
- Department of Biochemistry and Molecular Biology, Egerton University, Njoro, Kenya
| | - Julius O. Olumeh
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Isaiah Debrah
- West Africa Centre for Cell Biology of Infectious Pathogen, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Shirley A. Onyango
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Pauline W. Orondo
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Benyl M. Ondeto
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Harrysone E. Atieli
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Sidney O. Ogolla
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - John Githure
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Antony C. A. Otieno
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Andrew K. Githeko
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - James W. Kazura
- Centre for Global Health and Diseases, Case Western Reserve University, Cleveland, OH USA
| | - Wolfgang R. Mukabana
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Yan Guiyan
- Program in Public Health, College of Health Sciences, University of California, Irvine, USA
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