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Macalinao MLM, Fornace KM, Reyes RA, Hall T, Bareng APN, Adams JH, Huon C, Chitnis CE, Luchavez JS, Tetteh KK, Yui K, Hafalla JCR, Espino FEJ, Drakeley CJ. Analytical approaches for antimalarial antibody responses to confirm historical and recent malaria transmission: an example from the Philippines. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 37:100792. [PMID: 37693871 PMCID: PMC10485684 DOI: 10.1016/j.lanwpc.2023.100792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/20/2023] [Accepted: 04/28/2023] [Indexed: 09/12/2023]
Abstract
Background Assessing the status of malaria transmission in endemic areas becomes increasingly challenging as countries approach elimination. Serology can provide robust estimates of malaria transmission intensities, and multiplex serological assays allow for simultaneous assessment of markers of recent and historical malaria exposure. Methods Here, we evaluated different statistical and machine learning methods for analyzing multiplex malaria-specific antibody response data to classify recent and historical exposure to Plasmodium falciparum and Plasmodium vivax. To assess these methods, we utilized samples from a health-facility based survey (n = 9132) in the Philippines, where we quantified antibody responses against 8 P. falciparum and 6 P. vivax-specific antigens from 3 sites with varying transmission intensity. Findings Measurements of antibody responses and seroprevalence were consistent with the 3 sites' known endemicity status. Among the models tested, a machine learning (ML) approach (Random Forest model) using 4 serological markers (PfGLURP R2, Etramp5.Ag1, GEXP18, and PfMSP119) gave better predictions for P. falciparum recent infection in Palawan (AUC: 0.9591, CI 0.9497-0.9684) than individual antigen seropositivity. Although the ML approach did not improve P. vivax infection predictions, ML classifications confirmed the absence of recent exposure to P. falciparum and P. vivax in both Occidental Mindoro and Bataan. For predicting historical P. falciparum and P. vivax transmission, seroprevalence and seroconversion rates based on cumulative exposure markers AMA1 and MSP119 showed reliable trends in the 3 sites. Interpretation Our study emphasizes the utility of serological markers in predicting recent and historical exposure in a sub-national elimination setting, and also highlights the potential use of machine learning models using multiplex antibody responses to improve assessment of the malaria transmission status of countries aiming for elimination. This work also provides baseline antibody data for monitoring risk in malaria-endemic areas in the Philippines. Funding Newton Fund, Philippine Council for Health Research and Development, UK Medical Research Council.
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Affiliation(s)
- Maria Lourdes M. Macalinao
- Department of Parasitology and National Reference Laboratory for Malaria and Other Parasites, Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Philippines
- Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Kimberly M. Fornace
- Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Ralph A. Reyes
- Department of Parasitology and National Reference Laboratory for Malaria and Other Parasites, Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Philippines
| | - Tom Hall
- Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alison Paolo N. Bareng
- Department of Parasitology and National Reference Laboratory for Malaria and Other Parasites, Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Philippines
| | | | - Christèle Huon
- Malaria Parasite Biology and Vaccines Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Chetan E. Chitnis
- Malaria Parasite Biology and Vaccines Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Jennifer S. Luchavez
- Department of Parasitology and National Reference Laboratory for Malaria and Other Parasites, Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Philippines
| | - Kevin K.A. Tetteh
- Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katsuyuki Yui
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Shionogi Global Infectious Diseases Division, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Julius Clemence R. Hafalla
- Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fe Esperanza J. Espino
- Department of Parasitology and National Reference Laboratory for Malaria and Other Parasites, Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Philippines
| | - Chris J. Drakeley
- Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Chan Y, Martin D, Mace KE, Jean SE, Stresman G, Drakeley C, Chang MA, Lemoine JF, Udhayakumar V, Lammie PJ, Priest JW, Rogier EW. Multiplex Serology for Measurement of IgG Antibodies Against Eleven Infectious Diseases in a National Serosurvey: Haiti 2014-2015. Front Public Health 2022; 10:897013. [PMID: 35757611 PMCID: PMC9218545 DOI: 10.3389/fpubh.2022.897013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Integrated surveillance for multiple diseases can be an efficient use of resources and advantageous for national public health programs. Detection of IgG antibodies typically indicates previous exposure to a pathogen but can potentially also serve to assess active infection status. Serological multiplex bead assays have recently been developed to simultaneously evaluate exposure to multiple antigenic targets. Haiti is an island nation in the Caribbean region with multiple endemic infectious diseases, many of which have a paucity of data for population-level prevalence or exposure. Methods A nationwide serosurvey occurred in Haiti from December 2014 to February 2015. Filter paper blood samples (n = 4,438) were collected from participants in 117 locations and assayed for IgG antibodies on a multiplex bead assay containing 15 different antigens from 11 pathogens: Plasmodium falciparum, Toxoplasma gondii, lymphatic filariasis roundworms, Strongyloides stercoralis, chikungunya virus, dengue virus, Chlamydia trachomatis, Treponema pallidum, enterotoxigenic Escherichia coli, Entamoeba histolytica, and Cryptosporidium parvum. Results Different proportions of the Haiti study population were IgG seropositive to the different targets, with antigens from T. gondii, C. parvum, dengue virus, chikungunya virus, and C. trachomatis showing the highest rates of seroprevalence. Antibody responses to T. pallidum and lymphatic filariasis were the lowest, with <5% of all samples IgG seropositive to antigens from these pathogens. Clear trends of increasing seropositivity and IgG levels with age were seen for all antigens except those from chikungunya virus and E. histolytica. Parametric models were able to estimate the rate of seroconversion and IgG acquisition per year for residents of Haiti. Conclusions Multiplex serological assays can provide a wealth of information about population exposure to different infectious diseases. This current Haitian study included IgG targets for arboviral, parasitic, and bacterial infectious diseases representing multiple different modes of host transmission. Some of these infectious diseases had a paucity or complete absence of published serological studies in Haiti. Clear trends of disease burden with respect to age and location in Haiti can be used by national programs and partners for follow-up studies, resource allocation, and intervention planning.
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Affiliation(s)
- YuYen Chan
- The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Diana Martin
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kimberly E Mace
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Samuel E Jean
- Population Services International/Organization Haïtienne de Marketing Social Pour la Santé, Port-au-Prince, Haiti
| | - Gillian Stresman
- The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Chris Drakeley
- The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Michelle A Chang
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jean F Lemoine
- Programme National de Contrôle de la Malaria/MSPP, Port-au-Prince, Haiti
| | - Venkatachalam Udhayakumar
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Patrick J Lammie
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jeffrey W Priest
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eric William Rogier
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Wu L, Hsiang MS, Prach LM, Schrubbe L, Ntuku H, Dufour MSK, Whittemore B, Scott V, Yala J, Roberts KW, Patterson C, Biggs J, Hall T, Tetteh KK, Gueye CS, Greenhouse B, Bennett A, Smith JL, Katokele S, Uusiku P, Mumbengegwi D, Gosling R, Drakeley C, Kleinschmidt I. Serological evaluation of the effectiveness of reactive focal mass drug administration and reactive vector control to reduce malaria transmission in Zambezi Region, Namibia: Results from a secondary analysis of a cluster randomised trial. EClinicalMedicine 2022; 44:101272. [PMID: 35198913 PMCID: PMC8851292 DOI: 10.1016/j.eclinm.2022.101272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/20/2021] [Accepted: 01/06/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Due to challenges in measuring changes in malaria at low transmission, serology is increasingly being used to complement clinical and parasitological surveillance. Longitudinal studies have shown that serological markers, such as Etramp5.Ag1, can reflect spatio-temporal differences in malaria transmission. However, these markers have yet to be used as endpoints in intervention trials. METHODS Based on data from a 2017 cluster randomised trial conducted in Zambezi Region, Namibia, evaluating the effectiveness of reactive focal mass drug administration (rfMDA) and reactive vector control (RAVC), this study conducted a secondary analysis comparing antibody responses between intervention arms as trial endpoints. Antibody responses were measured on a multiplex immunoassay, using a panel of eight serological markers of Plasmodium falciparum infection - Etramp5.Ag1, GEXP18, HSP40.Ag1, Rh2.2030, EBA175, PfMSP119, PfAMA1, and PfGLURP.R2. FINDINGS Reductions in sero-prevalence to antigens Etramp.Ag1, PfMSP119, Rh2.2030, and PfAMA1 were observed in study arms combining rfMDA and RAVC, but only effects for Etramp5.Ag1 were statistically significant. Etramp5.Ag1 sero-prevalence was significantly lower in all intervention arms. Compared to the reference arms, adjusted prevalence ratio (aPR) for Etramp5.Ag1 was 0.78 (95%CI 0.65 - 0.91, p = 0.0007) in the rfMDA arms and 0.79 (95%CI 0.67 - 0.92, p = 0.001) in the RAVC arms. For the combined rfMDA plus RAVC intervention, aPR was 0.59 (95%CI 0.46 - 0.76, p < 0.0001). Significant reductions were also observed based on continuous antibody responses. Sero-prevalence as an endpoint was found to achieve higher study power (99.9% power to detect a 50% reduction in prevalence) compared to quantitative polymerase chain reaction (qPCR) prevalence (72.9% power to detect a 50% reduction in prevalence). INTERPRETATION While the observed relative reduction in qPCR prevalence in the study was greater than serology, the use of serological endpoints to evaluate trial outcomes measured effect size with improved precision and study power. Serology has clear application in cluster randomised trials, particularly in settings where measuring clinical incidence or infection is less reliable due to seasonal fluctuations, limitations in health care seeking, or incomplete testing and reporting. FUNDING This study was supported by Novartis Foundation (A122666), the Bill & Melinda Gates Foundation (OPP1160129), and the Horchow Family Fund (5,300,375,400).
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Affiliation(s)
- Lindsey Wu
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
- Corresponding author.
| | - Michelle S. Hsiang
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Lisa M. Prach
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Leah Schrubbe
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Henry Ntuku
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Mi-Suk Kang Dufour
- Division of Prevention Science, University of California San Francisco, San Francisco, CA, USA
| | - Brooke Whittemore
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Valerie Scott
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Joy Yala
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Kathryn W. Roberts
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Catriona Patterson
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Joseph Biggs
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Tom Hall
- St. George's University of London, London, UK
| | - Kevin K.A. Tetteh
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Cara Smith Gueye
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Bryan Greenhouse
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Jennifer L. Smith
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Stark Katokele
- National Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Petrina Uusiku
- National Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Davis Mumbengegwi
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Immo Kleinschmidt
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London, UK
- Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Wits Institute for Malaria Research, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
- Southern African Development Community Malaria Elimination Eight Secretariat, Windhoek, Namibia
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Sarkar R, Kessler A, Mawkhlieng B, Sullivan SA, Wilson ML, Carlton JM, Albert S. Household and individual level risk factors associated with declining malaria incidence in Meghalaya, India: implications for malaria elimination in low-endemic settings. Malar J 2021; 20:460. [PMID: 34895233 PMCID: PMC8665616 DOI: 10.1186/s12936-021-03982-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/12/2021] [Indexed: 01/02/2023] Open
Abstract
Background A detailed analysis of household and individual level Plasmodium infection patterns in two low-endemic districts of Meghalaya was undertaken to better understand the epidemiology of malaria in northeast India. Methods Socio-demographic and behavioural information from residents (aged 1–69 years) of households were collected through pre-tested, questionnaire conducted in 2018 and 2019. Blood samples collected from participants were tested for Plasmodium falciparum and/or Plasmodium vivax infection using rapid diagnostic test, microscopy and PCR. Plasma samples from a subset of participants were analysed for antibodies against thirteen P. falciparum and four P. vivax antigens. Associations between household and individual level risk factors, and Plasmodium infections were evaluated using multilevel logistic regression models. Results A total of 2753 individuals from 827 households were enrolled in 2018, and 834 individuals from 222 households were enrolled in 2019. Of them, 33 (1.2%) were positive by PCR for P. falciparum in 2018 and none were positive for P. vivax. In 2019, no PCR-positive individuals were detected. All, but one, infections were asymptomatic; all 33 infections were sub-microscopic. Reported history of malaria in the past 12 months (OR = 8.84) and history of travel in the past 14 days (OR = 10.06) were significantly associated with Plasmodium infection. A significant trend of increased seropositivity with age was noted for all 17 antigens. Although adults (≥ 18 years) consistently had the highest seropositivity rates, a sizeable proportion of under-five children were also found to be seropositive. Almost all individuals (99.4%) reported sleeping under an insecticide-treated bed-net, and household indoor residual spray coverage in the 12 months preceding the survey was low (23%). Most participants correctly identified common signs and symptoms of malaria, i.e., fever (96.4%), headache (71.2%), chills (83.2%) and body-ache (61.8%). Almost all participants (94.3%) used government-provided services for treatment of malaria. Conclusion This study explored the epidemiology of malaria in two communities in Meghalaya, India, in the context of declining transmission. The presence of widespread asymptomatic infections and seropositivity among under-five children suggest that low-level Plasmodium transmission persists in this region. Implications of the study findings for malaria elimination efforts in low-transmission settings are discussed.
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Affiliation(s)
- Rajiv Sarkar
- Indian Institute of Public Health - Shillong, Shillong, Meghalaya, 793001, India. .,Martin Luther Christian University, Shillong, Meghalaya, 793006, India.
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | | | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Mark L Wilson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jane M Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,Department of Epidemiology, School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Sandra Albert
- Indian Institute of Public Health - Shillong, Shillong, Meghalaya, 793001, India.,Martin Luther Christian University, Shillong, Meghalaya, 793006, India
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Xu Q, Liu S, Kassegne K, Yang B, Lu J, Sun Y, Zhong W, Zhang M, Liu Y, Zhu G, Cao J, Cheng Y. Genetic diversity and immunogenicity of the merozoite surface protein 1 C-terminal 19-kDa fragment of Plasmodium ovale imported from Africa into China. Parasit Vectors 2021; 14:583. [PMID: 34819151 PMCID: PMC8611641 DOI: 10.1186/s13071-021-05086-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Merozoite surface protein 1 (MSP1) plays an essential role in erythrocyte invasion by malaria parasites. The C-terminal 19-kDa region of MSP1 has long been considered one of the major candidate antigens for a malaria blood-stage vaccine against Plasmodium falciparum. However, there is limited information on the C-terminal 19-kDa region of Plasmodium ovale MSP1 (PoMSP119). This study aims to analyze the genetic diversity and immunogenicity of PoMSP119. Methods A total of 37 clinical Plasmodium ovale isolates including Plasmodium ovale curtisi and Plasmodium ovale wallikeri imported from Africa into China and collected during the period 2012–2016 were used. Genomic DNA was used to amplify P. ovale curtisi (poc) msp119 (pocmsp119) and P. ovale wallikeri (pow) msp119 (powmsp119) genes by polymerase chain reaction. The genetic diversity of pomsp119 was analyzed using the GeneDoc version 6 programs. Recombinant PoMSP119 (rPoMSP119)-glutathione S-transferase (GST) proteins were expressed in an Escherichia coli expression system and analyzed by western blot. Immune responses in BALB/c mice immunized with rPoMSP119-GST were determined using enzyme-linked immunosorbent assay. In addition, antigen-specific T cell responses were assessed by lymphocyte proliferation assays. A total of 49 serum samples from healthy individuals and individuals infected with P. ovale were used for the evaluation of natural immune responses by using protein microarrays. Results Sequences of pomsp119 were found to be thoroughly conserved in all the clinical isolates. rPoMSP119 proteins were efficiently expressed and purified as ~ 37-kDa proteins. High antibody responses in mice immunized with rPoMSP119-GST were observed. rPoMSP119-GST induced high avidity indexes, with an average of 92.57% and 85.32% for rPocMSP119 and rPowMSP119, respectively. Cross-reactivity between rPocMSP119 and rPowMSP119 was observed. Cellular immune responses to rPocMSP119 (69.51%) and rPowMSP119 (52.17%) induced in rPocMSP119- and rPowMSP119-immunized mice were found in the splenocyte proliferation assays. The sensitivity and specificity of rPoMSP119-GST proteins for the detection of natural immune responses in patients infected with P. ovale were 89.96% and 75%, respectively. Conclusions This study revealed highly conserved gene sequences of pomsp119. In addition, naturally acquired humoral immune responses against rPoMSP1 were observed in P. ovale infections, and high immunogenicity of rPoMSP119 in mice was also identified. These instructive findings should encourage further testing of PoMSP119 for rational vaccine design. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-05086-6.
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Affiliation(s)
- Qinwen Xu
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Sihong Liu
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasite Diseases, Wuxi, 214064, Jiangsu, People's Republic of China
| | - Kokouvi Kassegne
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Bo Yang
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Jiachen Lu
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Yifan Sun
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Wenli Zhong
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Miaosa Zhang
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Yaobao Liu
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasite Diseases, Wuxi, 214064, Jiangsu, People's Republic of China
| | - Guoding Zhu
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasite Diseases, Wuxi, 214064, Jiangsu, People's Republic of China
| | - Jun Cao
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China. .,Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasite Diseases, Wuxi, 214064, Jiangsu, People's Republic of China.
| | - Yang Cheng
- Laboratory of Pathogen Infection and Immunity, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, People's Republic of China.
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6
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Nchama VUNN, Said AH, Mtoro A, Bidjimi GO, Owono MA, Maye ERM, Mangue MEO, Okomo GNN, Pasialo BEN, Ondo DM, Lopez MSA, Mochomuemue FL, Obono MO, Besaha JCM, Chuquiyauri R, Jongo SA, Kamaka K, Kibondo UA, Athuman T, Falla CC, Eyono JNM, Smith JM, García GA, Raso J, Nyakarungu E, Mpina M, Schindler T, Daubenberger C, Lemiale L, Billingsley PF, Sim BKL, Richie TL, Church LWP, Olotu A, Tanner M, Hoffman SL, Abdulla S. Incidence of Plasmodium falciparum malaria infection in 6-month to 45-year-olds on selected areas of Bioko Island, Equatorial Guinea. Malar J 2021; 20:322. [PMID: 34284778 PMCID: PMC8290541 DOI: 10.1186/s12936-021-03850-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Extensive malaria control measures have been implemented on Bioko Island, Equatorial Guinea over the past 16 years, reducing parasite prevalence and malaria-related morbidity and mortality, but without achieving elimination. Malaria vaccines offer hope for reducing the burden to zero. Three phase 1/2 studies have been conducted successfully on Bioko Island to evaluate the safety and efficacy of whole Plasmodium falciparum (Pf) sporozoite (SPZ) malaria vaccines. A large, pivotal trial of the safety and efficacy of the radiation-attenuated Sanaria® PfSPZ Vaccine against P. falciparum is planned for 2022. This study assessed the incidence of malaria at the phase 3 study site and characterized the influence of socio-demographic factors on the burden of malaria to guide trial design. Methods A cohort of 240 randomly selected individuals aged 6 months to 45 years from selected areas of North Bioko Province, Bioko Island, was followed for 24 weeks after clearance of parasitaemia. Assessment of clinical presentation consistent with malaria and thick blood smears were performed every 2 weeks. Incidence of first and multiple malaria infections per person-time of follow-up was estimated, compared between age groups, and examined for associated socio-demographic risk factors. Results There were 58 malaria infection episodes observed during the follow up period, including 47 first and 11 repeat infections. The incidence of malaria was 0.25 [95% CI (0.19, 0.32)] and of first malaria was 0.23 [95% CI (0.17, 0.30)] per person per 24 weeks (0.22 in 6–59-month-olds, 0.26 in 5–17-year-olds, 0.20 in 18–45-year-olds). Incidence of first malaria with symptoms was 0.13 [95% CI (0.09, 0.19)] per person per 24 weeks (0.16 in 6–59-month-olds, 0.10 in 5–17-year-olds, 0.11 in 18–45-year-olds). Multivariate assessment showed that study area, gender, malaria positivity at screening, and household socioeconomic status independently predicted the observed incidence of malaria. Conclusion Despite intensive malaria control efforts on Bioko Island, local transmission remains and is spread evenly throughout age groups. These incidence rates indicate moderate malaria transmission which may be sufficient to support future larger trials of PfSPZ Vaccine. The long-term goal is to conduct mass vaccination programmes to halt transmission and eliminate P. falciparum malaria.
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Affiliation(s)
- Vicente Urbano Nsue Ndong Nchama
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Ali Hamad Said
- Medical Care Development International (MCDI), Silver Spring, USA. .,Ifakara Health Institute, Dar es Salaam, Tanzania.
| | - Ali Mtoro
- Medical Care Development International (MCDI), Silver Spring, USA.,Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Gertrudis Owono Bidjimi
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Marta Alene Owono
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Escolastica Raquel Mansogo Maye
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Martin Eka Ondo Mangue
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Genaro Nsue Nguema Okomo
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Beltran Ekua Ntutumu Pasialo
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Dolores Mbang Ondo
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Maria-Silvia Angue Lopez
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Fortunata Lobede Mochomuemue
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Mariano Obiang Obono
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Juan Carlos Momo Besaha
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Raul Chuquiyauri
- Medical Care Development International (MCDI), Silver Spring, USA.,Sanaria Inc., Rockville, USA
| | | | - Kassim Kamaka
- Medical Care Development International (MCDI), Silver Spring, USA.,Ifakara Health Institute, Dar es Salaam, Tanzania
| | | | | | | | | | | | | | - José Raso
- Ministry of Health and Social Welfare, Equatorial Guinea (EGMOHSW), Malabo, Equatorial Guinea.,Medical Care Development International (MCDI), Silver Spring, USA
| | - Elizabeth Nyakarungu
- Medical Care Development International (MCDI), Silver Spring, USA.,Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Maxmillian Mpina
- Ifakara Health Institute, Dar es Salaam, Tanzania.,Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Claudia Daubenberger
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | | | | | | | | | - Ally Olotu
- Medical Care Development International (MCDI), Silver Spring, USA.,Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
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7
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Kyei-Baafour E, Oppong M, Kusi KA, Frempong AF, Aculley B, Arthur FKN, Tiendrebeogo RW, Singh SK, Theisen M, Kweku M, Adu B, Hviid L, Ofori MF. Suitability of IgG responses to multiple Plasmodium falciparum antigens as markers of transmission intensity and pattern. PLoS One 2021; 16:e0249936. [PMID: 33886601 PMCID: PMC8062017 DOI: 10.1371/journal.pone.0249936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/27/2021] [Indexed: 12/05/2022] Open
Abstract
Detection of antibody reactivity to appropriate, specific parasite antigens may constitute a sensitive and cost-effective alternative to current tools to monitor malaria transmission across different endemicity settings. This study aimed to determine the suitability of IgG responses to a number of P. falciparum antigens as markers of transmission intensity and pattern. Antibody responses to multiple malaria antigens were determined in 905 participants aged 1–12 years from three districts with low (Keta), medium (Hohoe) and high (Krachi) transmission intensity in the Volta region of Ghana. Blood film microscopy slides and dry blood spots (DBS) were obtained for parasitaemia detection and antibody measurement, respectively. Sera were eluted from DBS and levels of IgG specific for 10 malaria antigens determined by a multiplex assay. Results were compared within and among the districts. Total IgG responses to MSPDBL1, MSPDBLLeucine, MSP2-FC27, RAMA, and PfRh2a and PfRh2b were higher in Krachi than in Hohoe and Keta. Seroprevalence of IgG specific for MSPDBLLeucine, RON4, and PfRh2b were also highest in Krachi. Responses to RALP-1, PfRh2a and PfRh2b were associated with patent but asymptomatic parasitaemia in Keta, while responses to MSPDBL1, MSPDBLLeucine, MSP2-FC27, RAMA, Rh2-2030, and PfRh2b were associated with parasite carriage in Hohoe, but not in Krachi. Using ROC analysis, only PfRh2b was found to predict patent, but asymptomatic, parasitaemia in Keta and Hohoe. Antibody breadth correlated positively with age (r = 0.29, p<0.0001) and parasitaemia (β = 3.91; CI = 1.53 to 6.29), and medium to high transmission (p<0.0001). Our findings suggest differences in malaria-specific antibody responses across the three transmission zones and that PfRh2b has potential as a marker of malaria transmission intensity and pattern. This could have implications for malaria control programs and vaccine trials.
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Affiliation(s)
- Eric Kyei-Baafour
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mavis Oppong
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Kwadwo Asamoah Kusi
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Abena Fremaah Frempong
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Belinda Aculley
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Fareed K. N. Arthur
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Regis Wendpayangde Tiendrebeogo
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, and at Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Susheel K. Singh
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, and at Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Michael Theisen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, and at Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Margaret Kweku
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Bright Adu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Lars Hviid
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, and at Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Michael Fokuo Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
- * E-mail:
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8
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Steinhardt LC, Ravaoarisoa E, Wiegand R, Harimanana A, Hedje J, Cotte AH, Zigirumugabe S, Kesteman T, Rasoloharimanana TL, Rakotomalala E, Randriamoramanana AM, Rakotondramanga JM, Razanatsiorimalala S, Mercereau-Puijalon O, Perraut R, Ratsimbasoa A, Butts J, Rogier C, Piola P, Randrianarivelojosia M, Vigan-Womas I. School-Based Serosurveys to Assess the Validity of Using Routine Health Facility Data to Target Malaria Interventions in the Central Highlands of Madagascar. J Infect Dis 2021; 223:995-1004. [PMID: 32761176 PMCID: PMC10940115 DOI: 10.1093/infdis/jiaa476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In low-malaria-transmission areas of Madagascar, annual parasite incidence (API) from routine data has been used to target indoor residual spraying at subdistrict commune level. To assess validity of this approach, we conducted school-based serological surveys and health facility (HF) data quality assessments in 7 districts to compare API to gold-standard commune-level serological measures. METHODS At 2 primary schools in each of 93 communes, 60 students were randomly selected with parents and teachers. Capillary blood was drawn for rapid diagnostic tests (RDTs) and serology. Multiplex bead-based immunoassays to detect antibodies to 5 Plasmodium falciparum antigens were conducted, and finite mixture models used to characterize seronegative and seropositive populations. Reversible catalytic models generated commune-level annual seroconversion rates (SCRs). HF register data were abstracted to assess completeness and accuracy. RESULTS RDT positivity from 12 770 samples was 0.5%. Seroprevalence to tested antigens ranged from 17.9% (MSP-1) to 59.7% (PF13). Median commune-level SCR was 0.0108 (range, 0.001-0.075). Compared to SCRs, API identified 71% (95% confidence interval, 51%-87%) of the 30% highest-transmission communes; sensitivity declined at lower levels. Routine data accuracy did not substantially affect API performance. CONCLUSIONS API performs reasonably well at identifying higher-transmission communes but sensitivity declined at lower transmission levels.
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Affiliation(s)
- Laura C Steinhardt
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elisabeth Ravaoarisoa
- Malaria Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Faculty of Sciences, University of Antananarivo, Antananarivo, Madagascar
| | - Ryan Wiegand
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aina Harimanana
- Epidemiology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Judith Hedje
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- US President's Malaria Initiative, Antananarivo, Madagascar
| | - Annett H Cotte
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sixte Zigirumugabe
- US President's Malaria Initiative, Antananarivo, Madagascar
- United States Agency for International Development, Washington, District of Columbia, USA
| | - Thomas Kesteman
- Malaria Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Fondation Merieux, Lyon, France
| | | | - Emma Rakotomalala
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | | | | | | | - Ronald Perraut
- Immunology Unit, Institut Pasteur de Dakar, Dakar, Senegal
| | - Arsène Ratsimbasoa
- National Malaria Control Program of Madagascar, Ministry of Public Health, Antananarivo, Madagascar
- Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar
- L'Institut Hospitalo-Universitaire en Maladies Infectieuses de Marseille, Marseille, France
| | - Jessica Butts
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christophe Rogier
- L'Institut Hospitalo-Universitaire en Maladies Infectieuses de Marseille, Marseille, France
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Patrice Piola
- Epidemiology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | - Inès Vigan-Womas
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
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9
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Bath D, Cook J, Govere J, Mathebula P, Morris N, Hlongwana K, Raman J, Seocharan I, Zitha A, Zitha M, Mabuza A, Mbokazi F, Machaba E, Mabunda E, Jamesboy E, Biggs J, Drakeley C, Moonasar D, Maharaj R, Coetzee M, Pitt C, Kleinschmidt I. Effectiveness and cost-effectiveness of reactive, targeted indoor residual spraying for malaria control in low-transmission settings: a cluster-randomised, non-inferiority trial in South Africa. Lancet 2021; 397:816-827. [PMID: 33640068 PMCID: PMC7910276 DOI: 10.1016/s0140-6736(21)00251-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/11/2020] [Accepted: 01/14/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Increasing insecticide costs and constrained malaria budgets could make universal vector control strategies, such as indoor residual spraying (IRS), unsustainable in low-transmission settings. We investigated the effectiveness and cost-effectiveness of a reactive, targeted IRS strategy. METHODS This cluster-randomised, open-label, non-inferiority trial compared reactive, targeted IRS with standard IRS practice in northeastern South Africa over two malaria seasons (2015-17). In standard IRS clusters, programme managers conducted annual mass spray campaigns prioritising areas using historical data, expert opinion, and other factors. In targeted IRS clusters, only houses of index cases (identified through passive surveillance) and their immediate neighbours were sprayed. The non-inferiority margin was 1 case per 1000 person-years. Health service costs of real-world implementation were modelled from primary and secondary data. Incremental costs per disability-adjusted life-year (DALY) were estimated and deterministic and probabilistic sensitivity analyses conducted. This study is registered with ClinicalTrials.gov, NCT02556242. FINDINGS Malaria incidence was 0·95 per 1000 person-years (95% CI 0·58 to 1·32) in the standard IRS group and 1·05 per 1000 person-years (0·72 to 1·38) in the targeted IRS group, corresponding to a rate difference of 0·10 per 1000 person-years (-0·38 to 0·59), demonstrating non-inferiority for targeted IRS (p<0·0001). Per additional DALY incurred, targeted IRS saved US$7845 (2902 to 64 907), giving a 94-98% probability that switching to targeted IRS would be cost-effective relative to plausible cost-effectiveness thresholds for South Africa ($2637 to $3557 per DALY averted). Depending on the threshold used, targeted IRS would remain cost-effective at incidences of less than 2·0-2·7 per 1000 person-years. Findings were robust to plausible variation in other parameters. INTERPRETATION Targeted IRS was non-inferior, safe, less costly, and cost-effective compared with standard IRS in this very-low-transmission setting. Saved resources could be reallocated to other malaria control and elimination activities. FUNDING Joint Global Health Trials.
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Affiliation(s)
- David Bath
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK; Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Jackie Cook
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - John Govere
- Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Phillemon Mathebula
- Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Natashia Morris
- Health GIS Centre, South African Medical Research Council, Durban, South Africa
| | - Khumbulani Hlongwana
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Jaishree Raman
- Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa
| | - Ishen Seocharan
- Biostatistics Unit, South African Medical Research Council, Durban, South Africa
| | - Alpheus Zitha
- Mpumalanga Provincial Malaria Control Programme, Nelspruit, South Africa
| | - Matimba Zitha
- Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aaron Mabuza
- Mpumalanga Provincial Malaria Control Programme, Nelspruit, South Africa
| | - Frans Mbokazi
- Mpumalanga Provincial Malaria Control Programme, Nelspruit, South Africa
| | - Elliot Machaba
- Limpopo Provincial Malaria Control Programme, Polokwane, South Africa
| | - Erik Mabunda
- Limpopo Provincial Malaria Control Programme, Polokwane, South Africa
| | - Eunice Jamesboy
- Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Joseph Biggs
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Devanand Moonasar
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa; South Africa National Malaria Programme, National Department of Health, Pretoria, South Africa
| | - Rajendra Maharaj
- Office of Malaria Research, South African Medical Research Council, Durban, South Africa; Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa
| | - Maureen Coetzee
- Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Catherine Pitt
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Immo Kleinschmidt
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Southern African Development Community Malaria Elimination Eight Secretariat, Windhoek, Namibia
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10
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A Model for Assessing the Quantitative Effects of Heterogeneous Affinity in Malaria Transmission along with Ivermectin Mass Administration. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Using an agent-based model of malaria, we present numerical evidence that in communities of individuals having an affinity varying within a broad range of values, disease transmission may increase up to 300%. Moreover, our findings provide new insight into how to combine different strategies for the prevention of malaria transmission. In particular, we uncover a relationship between the level of heterogeneity and the level of conventional and unconventional anti-malarial drug administration (ivermectin and gametocidal agents), which, when taken together, will define a control parameter, tuning between disease persistence and elimination. Finally, we also provide evidence that the entomological inoculation rate, as well as the product between parasite and sporozoite rates are both good indicators of malaria incidence in the presence of heterogeneity in disease transmission and may configure a possible improvement in that setting, upon classical standard measures such as the basic reproductive number.
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11
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Labadie-Bracho MY, van Genderen FT, Adhin MR. Malaria serology data from the Guiana shield: first insight in IgG antibody responses to Plasmodium falciparum, Plasmodium vivax and Plasmodium malariae antigens in Suriname. Malar J 2020; 19:360. [PMID: 33032606 PMCID: PMC7545893 DOI: 10.1186/s12936-020-03434-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/01/2020] [Indexed: 11/16/2022] Open
Abstract
Background Suriname has accomplished a steep decline in malaria burden, even reaching elimination levels. Plasmodium serology data are not available for Suriname and even extremely scarce within the region, therefore malaria serology testing was introduced, country customized cut-off values were determined and a study was performed to explore the antibody status for Plasmodium falciparum, Plasmodium vivax and Plasmodium malariae. Methods A cross-sectional survey was conducted between July 2017 and March 2018 in two areas of the interior with different malaria settings: Stoelmanseiland, representing Maroon villages and Benzdorp, a gold mining area, with mostly Brazilian miners. Dried blood spots (DBS) were collected (n = 197) and antibody presence against seven Plasmodium antigens was detected using a multiplex bead-based, IgG antibody assay. Demographic information was gathered through a questionnaire. Country customized cut-off values were generated from a Surinamese malaria-naïve reference population (n = 50). Results Serological analysis for the reference population revealed cut-off values ranging from 14 MFI for LSA-1 to 177 MFI for PmMSP-119. Seroprevalence against any of the three MSP-119 antibodies was similar in both regions and surpassed 75%. Single seropositivity against PfMSP-119 antibodies was higher in Stoelmanseiland (27.0%) than Benzdorp (9.3%), in line with the historical malaria burden of Stoelmanseiland, while the reverse was observed for PvMSP-119 antibodies. Despite sporadic reports of P. malariae infections, PmMSP-119 antibody presence was 39.6%. A more detailed examination of P. falciparum serology data displayed a higher seroprevalence in villagers (90.7%) than in Brazilians (64.6%) and a highly diverse antigenic response with 22 distinct antibody combinations. Conclusions The results on the malaria antibody signature of Maroon villagers and Brazilian miners living in Suriname displayed a high Plasmodium seroprevalence, especially for P. falciparum in villagers, still reflecting the historical malaria burden. The seroprevalence data for both regions and the observed combinations of P. falciparum antibodies provided a valuable dataset from a historically important region to the international malaria serology knowledge. First insight in malaria serology data for Suriname indicated that the use of other target groups and assessment of age-dependent seroprevalence are required to successfully use malaria serology as tool in the national elimination strategy.
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Affiliation(s)
| | - Farah T van Genderen
- Faculty of Medical Sciences, Department of Biochemistry, Anton de Kom Universiteit van Suriname, Kernkampweg 5, Paramaribo, Suriname
| | - Malti R Adhin
- Faculty of Medical Sciences, Department of Biochemistry, Anton de Kom Universiteit van Suriname, Kernkampweg 5, Paramaribo, Suriname.
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12
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Wu L, Mwesigwa J, Affara M, Bah M, Correa S, Hall T, Singh SK, Beeson JG, Tetteh KKA, Kleinschmidt I, D'Alessandro U, Drakeley C. Antibody responses to a suite of novel serological markers for malaria surveillance demonstrate strong correlation with clinical and parasitological infection across seasons and transmission settings in The Gambia. BMC Med 2020; 18:304. [PMID: 32972398 PMCID: PMC7517687 DOI: 10.1186/s12916-020-01724-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/30/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND As malaria transmission declines, sensitive diagnostics are needed to evaluate interventions and monitor transmission. Serological assays measuring malaria antibody responses offer a cost-effective detection method to supplement existing surveillance tools. METHODS A prospective cohort study was conducted from 2013 to 2015 in 12 villages across five administrative regions in The Gambia. Serological analysis included samples from the West Coast Region at the start and end of the season (July and December 2013) and from the Upper River Region in July and December 2013 and April and December 2014. Antigen-specific antibody responses to eight Plasmodium falciparum (P. falciparum) antigens-Etramp5.Ag1, GEXP18, HSP40.Ag1, Rh2.2030, EBA175 RIII-V, PfMSP119, PfAMA1, and PfGLURP.R2-were quantified using a multiplexed bead-based assay. The association between antibody responses and clinical and parasitological endpoints was estimated at the individual, household, and population level. RESULTS Strong associations were observed between clinical malaria and concurrent sero-positivity to Etramp5.Ag1 (aOR 4.60 95% CI 2.98-7.12), PfMSP119 (aOR 4.09 95% CI 2.60-6.44), PfAMA1 (aOR 2.32 95% CI 1.40-3.85), and PfGLURP.R2 (aOR 3.12, 95% CI 2.92-4.95), while asymptomatic infection was associated with sero-positivity to all antigens. Village-level sero-prevalence amongst children 2-10 years against Etramp5.Ag1, HSP40.Ag1, and PfMSP119 showed the highest correlations with clinical and P. falciparum infection incidence rates. For all antigens, there were increased odds of asymptomatic P. falciparum infection in subjects residing in a compound with greater than 50% sero-prevalence, with a 2- to 3-fold increase in odds of infection associated with Etramp5.Ag1, GEXP18, Rh2.2030, PfMSP119, and PfAMA1. For individuals residing in sero-positive compounds, the odds of clinical malaria were reduced, suggesting a protective effect. CONCLUSIONS At low transmission, long-lived antibody responses could indicate foci of malaria transmission that have been ongoing for several seasons or years. In settings where sub-patent infections are prevalent and fluctuate below the detection limit of polymerase chain reaction (PCR), the presence of short-lived antibodies may indicate recent infectivity, particularly in the dry season when clinical cases are rare. Serological responses may reflect a persistent reservoir of infection, warranting community-targeted interventions if individuals are not clinically apparent but have the potential to transmit. Therefore, serological surveillance at the individual and household level may be used to target interventions where there are foci of asymptomatically infected individuals, such as by measuring the magnitude of age-stratified antibody levels or identifying areas with clustering of above-average antibody responses across a diverse range of serological markers.
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Affiliation(s)
- Lindsey Wu
- Faculty of Infectious Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine (LSHTM), London, WC1E 7HT, UK.
| | - Julia Mwesigwa
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Muna Affara
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Arusha, Tanzania
| | - Mamadou Bah
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Simon Correa
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Tom Hall
- St. George's University of London (SGUL), London, UK
| | - Susheel K Singh
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark.,Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - James G Beeson
- Burnet Institute, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Kevin K A Tetteh
- Faculty of Infectious Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine (LSHTM), London, WC1E 7HT, UK
| | - Immo Kleinschmidt
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, WC1E 7HT, UK.,School of Pathology, Wits Institute for Malaria Research, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Chris Drakeley
- Faculty of Infectious Tropical Diseases, Department of Infection Biology, London School of Hygiene and Tropical Medicine (LSHTM), London, WC1E 7HT, UK
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13
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Surendra H, Supargiyono, Ahmad RA, Kusumasari RA, Rahayujati TB, Damayanti SY, Tetteh KKA, Chitnis C, Stresman G, Cook J, Drakeley C. Using health facility-based serological surveillance to predict receptive areas at risk of malaria outbreaks in elimination areas. BMC Med 2020; 18:9. [PMID: 31987052 PMCID: PMC6986103 DOI: 10.1186/s12916-019-1482-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/09/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In order to improve malaria burden estimates in low transmission settings, more sensitive tools and efficient sampling strategies are required. This study evaluated the use of serological measures from repeated health facility-based cross-sectional surveys to investigate Plasmodium falciparum and Plasmodium vivax transmission dynamics in an area nearing elimination in Indonesia. METHODS Quarterly surveys were conducted in eight public health facilities in Kulon Progo District, Indonesia, from May 2017 to April 2018. Demographic data were collected from all clinic patients and their companions, with household coordinates collected using participatory mapping methods. In addition to standard microscopy tests, bead-based serological assays were performed on finger-prick bloodspot samples from 9453 people. Seroconversion rates (SCR, i.e. the proportion of people in the population who are expected to seroconvert per year) were estimated by fitting a simple reversible catalytic model to seroprevalence data. Mixed effects logistic regression was used to examine factors associated with malaria exposure, and spatial analysis was performed to identify areas with clustering of high antibody responses. RESULTS Parasite prevalence by microscopy was extremely low (0.06% (95% confidence interval 0.03-0.14, n = 6) and 0 for P. vivax and P. falciparum, respectively). However, spatial analysis of P. vivax antibody responses identified high-risk areas that were subsequently the site of a P. vivax outbreak in August 2017 (62 cases detected through passive and reactive detection systems). These areas overlapped with P. falciparum high-risk areas and were detected in each survey. General low transmission was confirmed by the SCR estimated from a pool of the four surveys in people aged 15 years old and under (0.020 (95% confidence interval 0.017-0.024) and 0.005 (95% confidence interval 0.003-0.008) for P. vivax and P. falciparum, respectively). The SCR estimates in those over 15 years old were 0.066 (95% confidence interval 0.041-0.105) and 0.032 (95% confidence interval 0.015-0.069) for P. vivax and P. falciparum, respectively. CONCLUSIONS These findings demonstrate the potential use of health facility-based serological surveillance to better identify and target areas still receptive to malaria in an elimination setting. Further implementation research is needed to enable integration of these methods with existing surveillance systems.
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Affiliation(s)
- Henry Surendra
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
| | - Supargiyono
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, 55281 Indonesia
| | - Riris A. Ahmad
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, 55281 Indonesia
| | - Rizqiani A. Kusumasari
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, 55281 Indonesia
| | | | - Siska Y. Damayanti
- District Health Office of Kulon Progo, Jln. Suparman No 1, Wates, 55611 Indonesia
| | - Kevin K. A. Tetteh
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | | | - Gillian Stresman
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - Jackie Cook
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
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14
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Seck MC, Thwing J, Badiane AS, Rogier E, Fall FB, Ndiaye PI, Diongue K, Mbow M, Ndiaye M, Diallo MA, Gomis JF, Mbaye A, Ndiaye T, Gaye A, Sy M, Déme AB, Ndiaye YD, Ndiaye D. Analysis of anti-Plasmodium IgG profiles among Fulani nomadic pastoralists in northern Senegal to assess malaria exposure. Malar J 2020; 19:15. [PMID: 31931834 PMCID: PMC6958760 DOI: 10.1186/s12936-020-3114-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Northern Senegal is a zone of very low malaria transmission, with an annual incidence of < 5/1000 inhabitants. This area, where the Senegal National Malaria Control Programme has initiated elimination activities, hosts Fulani, nomadic, pastoralists that spend the dry season in the south where malaria incidence is higher (150-450/1000 inhabitants) and return to the north with the first rains. Previous research demonstrated parasite prevalence of < 1% in this Fulani population upon return from the south, similar to that documented in the north in cross-sectional surveys. METHODS A modified snowball sampling survey of nomadic pastoralists was conducted in five districts in northern Senegal during September and October 2014. Demographic information and dried blood spots were collected. Multiplex bead-based assays were used to assess antibody responses to merozoite surface protein (MSP-119) antigen of the four primary Plasmodium species, as well as circumsporozoite protein (CSP) and liver stage antigen (LSA-1) of Plasmodium falciparum. RESULTS In the five study districts, 1472 individuals were enrolled, with a median age of 22 years (range 1 to 80 years). Thirty-two percent of subjects were under 14 years and 57% were male. The overall seroprevalence of P. falciparum MSP-119, CSP and LSA-1 antibodies were 45, 12 and 5%, respectively. Plasmodium falciparum MSP-119 antibody responses increased significantly with age in all study areas, and were significantly higher among males. The highest seroprevalence to P. falciparum antigens was observed in the Kanel district (63%) and the lowest observed in Podor (28%). Low seroprevalence was observed for non-falciparum species in all the study sites: 0.4, 0.7 and 1.8%, respectively, for Plasmodium ovale, Plasmodium vivax and Plasmodium malariae MSP-1. Antibody responses to P. vivax were observed in all study sites except Kanel. CONCLUSION Prevalence of P. falciparum MSP-119 antibodies and increases by study participant age provided data for low levels of exposure among this transient nomadic population. In addition, antibody responses to P. falciparum short half-life markers (CSP and LSA-1) and non-falciparum species were low. Further investigations are needed to understand the exposure of the Fulani population to P. vivax.
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Affiliation(s)
- Mame Cheikh Seck
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal. .,Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal.
| | - Julie Thwing
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA
| | - Aida Sadikh Badiane
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal.,Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA
| | - Fatou Ba Fall
- Senegal National Malaria Control Programme, Dakar, Senegal
| | - Pape Ibrahima Ndiaye
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Khadim Diongue
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal.,Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Moustapha Mbow
- Department of Immunology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal
| | - Mouhamadou Ndiaye
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal.,Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Mamadou Alpha Diallo
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Jules François Gomis
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Aminata Mbaye
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Tolla Ndiaye
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Aminata Gaye
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Mohamad Sy
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Awa Bineta Déme
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Yaye Die Ndiaye
- Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Daouda Ndiaye
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal.,Laboratory of Parasitology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
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15
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Surendra H, Wijayanti MA, Murhandarwati EH, Irnawati, Yuniarti T, Mardiati, Herdiana, Sumiwi ME, Hawley WA, Lobo NF, Cook J, Drakeley C, Supargiyono. Analysis of serological data to investigate heterogeneity of malaria transmission: a community-based cross-sectional study in an area conducting elimination in Indonesia. Malar J 2019; 18:227. [PMID: 31286973 PMCID: PMC6615161 DOI: 10.1186/s12936-019-2866-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/03/2019] [Indexed: 01/22/2023] Open
Abstract
Background Analysis of anti-malarial antibody responses has the potential to improve characterization of the variation in exposure to infection in low transmission settings, where conventional measures, such as entomological estimates and parasitaemia point prevalence become less sensitive and expensive to measure. This study evaluates the use of sero-epidemiological analysis to investigate heterogeneity of transmission in area conducting elimination in Indonesia. Methods Filter paper bloodspots and epidemiological data were collected through a community-based cross-sectional study conducted in two sub-districts in Sabang municipality, Aceh province, Indonesia in 2013. Antibody responses to merozoite surface protein 1 (MSP-119) and apical membrane antigen 1 (AMA-1) for Plasmodium falciparum and Plasmodium vivax were measured using indirect enzyme-linked immunosorbent assay (ELISA). Seroconversion rates (SCR) were estimated by fitting a simple reversible catalytic model to seroprevalence data for each antibody. Spatial analysis was performed using a Normal model (SaTScan v.9.4.2) to identify the clustering of higher values of household antibody responses. Multiple logistic regression was used to investigate factors associated with exposure. Results 1624 samples were collected from 605 households. Seroprevalence to any P. falciparum antigen was higher than to any P. vivax antigen, 6.9% (95% CI 5.8–8.2) vs 2.0% (95% CI 1.4–2.8). SCR estimates suggest that there was a significant change in P. falciparum transmission with no exposure seen in children under 5 years old. Plasmodium falciparum SCR in over 5 years old was 0.008 (95% CI 0.003–0.017) and 0.012 (95% CI 0.005–0.030) in Sukakarya and Sukajaya sub-districts, respectively. Clusters of exposure were detected for both P. falciparum and P. vivax, most of them in Sukajaya sub-district. Higher age, P. vivax seropositivity and use of long-lasting insecticide-treated bed net (LLIN) were associated with higher P. falciparum exposure. Conclusion Analysis of community-based serological data helps describe the level of transmission, heterogeneity and factors associated with malaria transmission in Sabang. This approach could be an important additional tool for malaria monitoring and surveillance in low transmission settings in Indonesia. Electronic supplementary material The online version of this article (10.1186/s12936-019-2866-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Henry Surendra
- Infection Biology Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK. .,Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
| | - Mahardika A Wijayanti
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.,Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Elsa H Murhandarwati
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.,Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Irnawati
- Sabang Municipal Health Office, Sabang, Aceh, Indonesia
| | | | - Mardiati
- Sabang Municipal Health Office, Sabang, Aceh, Indonesia
| | - Herdiana
- Child Survival and Development Cluster, UNICEF Aceh Field Office, Jakarta, Indonesia
| | - Maria E Sumiwi
- Child Survival and Development Cluster, UNICEF Aceh Field Office, Jakarta, Indonesia
| | - William A Hawley
- Child Survival and Development Cluster, UNICEF Indonesia Country Office, Jakarta, Indonesia
| | - Neil F Lobo
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
| | - Jackie Cook
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Chris Drakeley
- Infection Biology Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Supargiyono
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.,Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
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16
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Kobayashi T, Jain A, Liang L, Obiero JM, Hamapumbu H, Stevenson JC, Thuma PE, Lupiya J, Chaponda M, Mulenga M, Mamini E, Mharakurwa S, Gwanzura L, Munyati S, Mutambu S, Felgner P, Davies DH, Moss WJ. Distinct Antibody Signatures Associated with Different Malaria Transmission Intensities in Zambia and Zimbabwe. mSphere 2019; 4:e00061-19. [PMID: 30918058 PMCID: PMC6437277 DOI: 10.1128/mspheredirect.00061-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 02/08/2019] [Indexed: 12/30/2022] Open
Abstract
Antibodies to Plasmodium falciparum are specific biomarkers that can be used to monitor parasite exposure over broader time frames than microscopy, rapid diagnostic tests, or molecular assays. Consequently, seroprevalence surveys can assist with monitoring the impact of malaria control interventions, particularly in the final stages of elimination, when parasite incidence is low. The protein array format to measure antibodies to diverse P. falciparum antigens requires only small sample volumes and is high throughput, permitting the monitoring of malaria transmission on large spatial and temporal scales. We expanded the use of a protein microarray to assess malaria transmission in settings beyond those with a low malaria incidence. Antibody responses in children and adults were profiled, using a P. falciparum protein microarray, through community-based surveys in three areas in Zambia and Zimbabwe at different stages of malaria control and elimination. These three epidemiological settings had distinct serological profiles reflective of their malaria transmission histories. While there was little correlation between transmission intensity and antibody signals (magnitude or breadth) in adults, there was a clear correlation in children younger than 5 years of age. Antibodies in adults appeared to be durable even in the absence of significant recent transmission, whereas antibodies in children provided a more accurate picture of recent levels of transmission intensity. Seroprevalence studies in children could provide a valuable marker of progress toward malaria elimination.IMPORTANCE As malaria approaches elimination in many areas of the world, monitoring the effect of control measures becomes more important but challenging. Low-level infections may go undetected by conventional tests that depend on parasitemia, particularly in immune individuals, who typically show no symptoms of malaria. In contrast, antibodies persist after parasitemia and may provide a more accurate picture of recent exposure. Only a few parasite antigens-mainly vaccine candidates-have been evaluated in seroepidemiological studies. We examined antibody responses to 500 different malaria proteins in blood samples collected through community-based surveillance from areas with low, medium, and high malaria transmission intensities. The breadth of the antibody responses in adults was broad in all three settings and was a poor correlate of recent exposure. In contrast, children represented a better sentinel population for monitoring recent malaria transmission. These data will help inform the use of multiplex serology for malaria surveillance.
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Affiliation(s)
- Tamaki Kobayashi
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Aarti Jain
- Vaccine Research & Development Center, Department of Physiology & Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Li Liang
- Vaccine Research & Development Center, Department of Physiology & Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Joshua M Obiero
- Vaccine Research & Development Center, Department of Physiology & Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | | | - Jennifer C Stevenson
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Macha Research Trust, Choma, Zambia
| | - Philip E Thuma
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Macha Research Trust, Choma, Zambia
| | - James Lupiya
- Tropical Diseases Research Centre, Ndola, Zambia
| | | | | | - Edmore Mamini
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | | | - Shungu Munyati
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Susan Mutambu
- National Institute of Health Research, Harare, Zimbabwe
| | - Philip Felgner
- Vaccine Research & Development Center, Department of Physiology & Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - D Huw Davies
- Vaccine Research & Development Center, Department of Physiology & Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - William J Moss
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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17
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Greenhouse B, Daily J, Guinovart C, Goncalves B, Beeson J, Bell D, Chang MA, Cohen JM, Ding X, Domingo G, Eisele TP, Lammie PJ, Mayor A, Merienne N, Monteiro W, Painter J, Rodriguez I, White M, Drakeley C, Mueller I. Priority use cases for antibody-detecting assays of recent malaria exposure as tools to achieve and sustain malaria elimination. Gates Open Res 2019; 3:131. [PMID: 31172051 PMCID: PMC6545519 DOI: 10.12688/gatesopenres.12897.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 01/12/2023] Open
Abstract
Measurement of malaria specific antibody responses represents a practical and informative method for malaria control programs to assess recent exposure to infection. Technical advances in recombinant antigen production, serological screening platforms, and analytical methods have enabled the identification of several target antigens for laboratory based and point-of-contact tests. Questions remain as to how these serological assays can best be integrated into malaria surveillance activities to inform programmatic decision-making. This report synthesizes discussions from a convening at Institut Pasteur in Paris in June 2017 aimed at defining practical and informative use cases for serology applications and highlights five programmatic uses for serological assays including: documenting the absence of transmission; stratification of transmission; measuring the effect of interventions; informing a decentralized immediate response; and testing and treating P. vivax hypnozoite carriers.
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Affiliation(s)
- Bryan Greenhouse
- Department of Medicine,, University of California San Francisco, San Francisco, CA, USA
| | | | - Caterina Guinovart
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- PATH, Seattle, WA, USA
| | | | | | - David Bell
- Intellectual Ventures, Bellevue, WA, USA
| | | | | | | | | | - Thomas P. Eisele
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Wuelto Monteiro
- Tropical Medicine Foundation Dr. Heitor Viera Dourado, Manaus, Amazonas, Brazil
| | - John Painter
- Centers of Disease Control and Prevention, Atlanta, GA, USA
| | - Isabel Rodriguez
- Department of Medicine,, University of California San Francisco, San Francisco, CA, USA
| | | | - Chris Drakeley
- London School of Tropical Medicine & Hygiene, London, UK
| | - Ivo Mueller
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - The Malaria Serology Convening
- Department of Medicine,, University of California San Francisco, San Francisco, CA, USA
- Consultant to UNITAID, Denver, CO, USA
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- PATH, Seattle, WA, USA
- London School of Tropical Medicine & Hygiene, London, UK
- The Burnet Institute, Melbourne, Australia
- Intellectual Ventures, Bellevue, WA, USA
- Centers of Disease Control and Prevention, Atlanta, GA, USA
- Clinton Health Access Initiative (CHAI), Boston, MA, USA
- FIND, Geneva, Switzerland
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Institut Pasteur, Paris, France
- Tropical Medicine Foundation Dr. Heitor Viera Dourado, Manaus, Amazonas, Brazil
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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18
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Ya-Umphan P, Cerqueira D, Cottrell G, Parker DM, Fowkes FJI, Nosten F, Corbel V. Anopheles Salivary Biomarker as a Proxy for Estimating Plasmodium falciparum Malaria Exposure on the Thailand-Myanmar Border. Am J Trop Med Hyg 2018; 99:350-356. [PMID: 29869601 DOI: 10.4269/ajtmh.18-0081] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Timely identification and treatment of malaria transmission "hot spots" is essential to achieve malaria elimination. Here we investigate the relevance of using an Anopheles salivary biomarker to estimate Plasmodium falciparum malaria exposure risk along the Thailand-Myanmar border to guide malaria control. Between May 2013 and December 2014, > 9,000 blood samples collected in a cluster randomized control trial were screened with serological assays to measure the antibody responses to Anopheles salivary antigen (gSG6-P1) and P. falciparum malaria antigens (circumsporozoite protein, merozoite surface protein 119 [MSP-119]). Plasmodium falciparum infections were monitored through passive and active case detection. Seroprevalence to gSG6-P1, MSP-119, and CSP were 71.8% (95% Confidence interval [CI]: 70.9, 72.7), 68.6% (95% CI: 67.7, 69.5), and 8.6% (95% CI: 8.0, 9.2), respectively. Multivariate analysis showed that individuals with the highest Ab response to gSG6-P1 had six times the odds of being positive to CSP antigens (P < 0.001) and two times the odds of P. falciparum infection compared with low gSG6-P1 responders (P = 0.004). Spatial scan statistics revealed the presence of clusters of gSG6-P1 that partially overlapped P. falciparum infections. The gSG6-P1 salivary biomarker represents a good proxy for estimating P. falciparum malaria risk and could serve to implement hot spot-targeted vector control interventions to achieve malaria elimination.
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Affiliation(s)
- Phubeth Ya-Umphan
- Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (IRD 224-CNRS 5290 UM1-UM2), Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier, France
| | - Dominique Cerqueira
- Shoklo Malaria Research Unit, Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | - Gilles Cottrell
- Institut de Recherche pour le Développement (IRD), Université Paris Descartes, Sorbonne Paris Cité, UMR 216, Paris, France
| | - Daniel M Parker
- Department of Population Health and Disease Prevention, University of California, Irvine, California.,Shoklo Malaria Research Unit, Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | - Freya J I Fowkes
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.,Disease Elimination Program, Life Sciences, Burnet Institute, Melbourne, Australia
| | - Francois Nosten
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford Old Road Campus, Oxford, United Kingdom.,Shoklo Malaria Research Unit, Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand
| | - Vincent Corbel
- Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (IRD 224-CNRS 5290 UM1-UM2), Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier, France
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19
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Micro-epidemiology of malaria in an elimination setting in Central Vietnam. Malar J 2018; 17:119. [PMID: 29554901 PMCID: PMC5859719 DOI: 10.1186/s12936-018-2262-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/08/2018] [Indexed: 11/10/2022] Open
Abstract
Background In Vietnam, malaria persists in remote forested regions where infections are spatially heterogeneous, mostly asymptomatic and with low parasite density. Previous studies in Vietnam have investigated broad behavioural concepts such as ‘engaging in forest activities’ as risk factors for malaria infection, which may not explain heterogeneity in malaria risk, especially in malaria elimination settings. Methods A mixed methods study combining ethnographic research and a cross-sectional survey was embedded in a 1-year malariometric cohort study in three ethnic minority villages in South Tra My district, Quang Nam Province in Central Vietnam. Qualitative data collection included in-depth interviews, informal conversations and participant observations over a 2-month period, and the findings were used to develop the questionnaire used in the cross-sectional survey. The latter collected data on evening activities, mobility patterns and household characteristics. The primary outcome, recent exposure to malaria, was defined using the classification and regression tree method to determine significant changes in antibody titres during the year preceding the survey. Risk factor analyses for recent exposure to malaria were conducted using logistic regression. Results 22 in-depth interviews and numerous participant observations were recorded during the ethnographic research (April to June 2015), and 160 adults (86% response rate) responded to the cross-sectional survey (November to December 2015). Recent exposure to Plasmodium falciparum malaria was estimated at 22.9 and at 17.1% for Plasmodium vivax. Ongoing malaria transmission appears to be maintained by activities that delay or disrupt sleeping in a permanent structure in which a bed net could be hung, including evening drinking gatherings, fishing, logging in the forest and outdoor TV watching. Conclusions Vector control tools for outdoor evening activities in villages as well as at farms, forest and river locations should be incorporated into current malaria elimination efforts in Central Vietnam. Micro-epidemiology studies using mixed-methods designs can provide a comprehensive understanding of the malaria risk at fine spatial scales and better inform the implementation of targeted interventions for malaria elimination. Electronic supplementary material The online version of this article (10.1186/s12936-018-2262-0) contains supplementary material, which is available to authorized users.
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Medzihradsky OF, Kleinschmidt I, Mumbengegwi D, Roberts KW, McCreesh P, Dufour MSK, Uusiku P, Katokele S, Bennett A, Smith J, Sturrock H, Prach LM, Ntuku H, Tambo M, Didier B, Greenhouse B, Gani Z, Aerts A, Gosling R, Hsiang MS. Study protocol for a cluster randomised controlled factorial design trial to assess the effectiveness and feasibility of reactive focal mass drug administration and vector control to reduce malaria transmission in the low endemic setting of Namibia. BMJ Open 2018; 8:e019294. [PMID: 29374672 PMCID: PMC5829876 DOI: 10.1136/bmjopen-2017-019294] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION To interrupt malaria transmission, strategies must target the parasite reservoir in both humans and mosquitos. Testing of community members linked to an index case, termed reactive case detection (RACD), is commonly implemented in low transmission areas, though its impact may be limited by the sensitivity of current diagnostics. Indoor residual spraying (IRS) before malaria season is a cornerstone of vector control efforts. Despite their implementation in Namibia, a country approaching elimination, these methods have been met with recent plateaus in transmission reduction. This study evaluates the effectiveness and feasibility of two new targeted strategies, reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) in Namibia. METHODS AND ANALYSIS This is an open-label cluster randomised controlled trial with 2×2 factorial design. The interventions include: rfMDA (presumptive treatment with artemether-lumefantrine (AL)) versus RACD (rapid diagnostic testing and treatment using AL) and RAVC (IRS with Acellic 300CS) versus no RAVC. Factorial design also enables comparison of the combined rfMDA+RAVC intervention to RACD. Participants living in 56 enumeration areas will be randomised to one of four arms: rfMDA, rfMDA+RAVC, RACD or RACD+RAVC. These interventions, triggered by index cases detected at health facilities, will be targeted to individuals residing within 500 m of an index. The primary outcome is cumulative incidence of locally acquired malaria detected at health facilities over 1 year. Secondary outcomes include seroprevalence, infection prevalence, intervention coverage, safety, acceptability, adherence, cost and cost-effectiveness. ETHICS AND DISSEMINATION Findings will be reported on clinicaltrials.gov, in peer-reviewed publications and through stakeholder meetings with MoHSS and community leaders in Namibia. TRIAL REGISTRATION NUMBER NCT02610400; Pre-results.
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Affiliation(s)
- Oliver F Medzihradsky
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
- Department of Pediatrics, Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Immo Kleinschmidt
- Department of Infectious Disease Epidemiology, The London School of Hygiene and Tropical Medicine, London, UK
- Faculty of Health Sciences, School of Pathology, University of Witwatersrand, Johannesburg, South Africa
| | - Davis Mumbengegwi
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Kathryn W Roberts
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Patrick McCreesh
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mi-Suk Kang Dufour
- Division of Prevention Science, University of California San Francisco, San Francisco, California, USA
| | - Petrina Uusiku
- National Vector-borne Diseases Control Programme, Ministry of Health and Social Services, Windhoek, Namibia
| | - Stark Katokele
- National Vector-borne Diseases Control Programme, Ministry of Health and Social Services, Windhoek, Namibia
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Jennifer Smith
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Hugh Sturrock
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Lisa M Prach
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Henry Ntuku
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Munyaradzi Tambo
- Faculty of Health Sciences, School of Pathology, University of Witwatersrand, Johannesburg, South Africa
| | - Bradley Didier
- Clinton Health Access Initiative, Boston, Massachusetts, USA
| | - Bryan Greenhouse
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Ann Aerts
- Novartis Foundation, Basel, Switzerland
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Michelle S Hsiang
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
- Department of Pediatrics, Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Naturally acquired antibody response to Plasmodium falciparum describes heterogeneity in transmission on islands in Lake Victoria. Sci Rep 2017; 7:9123. [PMID: 28831122 PMCID: PMC5567232 DOI: 10.1038/s41598-017-09585-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/25/2017] [Indexed: 11/09/2022] Open
Abstract
As markers of exposure anti-malaria antibody responses can help characterise heterogeneity in malaria transmission. In the present study antibody responses to Plasmodium falciparum AMA-1, MSP-119 and CSP were measured with the aim to describe transmission patterns in meso-endemic settings in Lake Victoria. Two cross-sectional surveys were conducted in Lake Victoria in January and August 2012. The study area comprised of three settings: mainland (Ungoye), large island (Mfangano) and small islands (Takawiri, Kibuogi, Ngodhe). Individuals provided a finger-blood sample to assess malaria infection by microscopy and PCR. Antibody response to P. falciparum was determined in 4,112 individuals by ELISA using eluted dried blood from filter paper. The overall seroprevalence was 64.0% for AMA-1, 39.5% for MSP-119, and 12.9% for CSP. Between settings, seroprevalences for merozoite antigens were similar between Ungoye and Mfangano, but higher when compared to the small islands. For AMA-1, the seroconversion rates (SCRs) ranged from 0.121 (Ngodhe) to 0.202 (Ungoye), and were strongly correlated to parasite prevalence. We observed heterogeneity in serological indices across study sites in Lake Victoria. These data suggest that AMA-1 and MSP-119 sero-epidemiological analysis may provide further evidence in assessing variation in malaria exposure and evaluating malaria control efforts in high endemic area.
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