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Benjamin-Chung J, Li H, Nguyen A, Barratt Heitmann G, Bennett A, Ntuku H, Prach LM, Tambo M, Wu L, Drakeley C, Gosling R, Mumbengegwi D, Kleinschmidt I, Smith JL, Hubbard A, van der Laan M, Hsiang MS. Extension of efficacy range for targeted malaria-elimination interventions due to spillover effects. Nat Med 2024; 30:2813-2820. [PMID: 38965434 PMCID: PMC11483210 DOI: 10.1038/s41591-024-03134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 06/13/2024] [Indexed: 07/06/2024]
Abstract
Malaria-elimination interventions aim to extinguish hotspots and prevent transmission to nearby areas. Here, we re-analyzed a cluster-randomized trial of reactive, focal interventions (chemoprevention using artemether-lumefantrine and/or indoor residual spraying with pirimiphos-methyl) delivered within 500 m of confirmed malaria index cases in Namibia to measure direct effects (among intervention recipients within 500 m) and spillover effects (among non-intervention recipients within 3 km) on incidence, prevalence and seroprevalence. There was no or weak evidence of direct effects, but the sample size of intervention recipients was small, limiting statistical power. There was the strongest evidence of spillover effects of combined chemoprevention and indoor residual spraying. Among non-recipients within 1 km of index cases, the combined intervention reduced malaria incidence by 43% (95% confidence interval, 20-59%). In analyses among non-recipients within 3 km of interventions, the combined intervention reduced infection prevalence by 79% (6-95%) and seroprevalence, which captures recent infections and has higher statistical power, by 34% (20-45%). Accounting for spillover effects increased the cost-effectiveness of the combined intervention by 42%. Targeting hotspots with combined chemoprevention and vector-control interventions can indirectly benefit non-recipients up to 3 km away.
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Affiliation(s)
- Jade Benjamin-Chung
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
- Chan Zuckerberg Biohub, San Francisco, CA, USA.
| | - Haodong Li
- Division of Biostatistics, University of California, Berkeley, Berkeley, CA, USA
| | - Anna Nguyen
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | | | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, USA
- PATH, Seattle, WA, USA
| | - Henry Ntuku
- Malaria Elimination Initiative, Global Health Group, 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, USA
| | - Munyaradzi Tambo
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Lindsey Wu
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, USA
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Immo Kleinschmidt
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Wits Research Institute for Malaria, Wits/SAMRC Collaborating Centre for Multi-Disciplinary Research on 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
| | - Jennifer L Smith
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Alan Hubbard
- Division of Biostatistics, University of California, Berkeley, Berkeley, CA, USA
| | - Mark van der Laan
- Division of Biostatistics, University of California, Berkeley, Berkeley, CA, USA
| | - Michelle S Hsiang
- Chan Zuckerberg Biohub, San Francisco, CA, USA
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Fonseca A, Spytek M, Biecek P, Cordeiro C, Sepúlveda N. Antibody selection strategies and their impact in predicting clinical malaria based on multi-sera data. BioData Min 2024; 17:2. [PMID: 38273386 PMCID: PMC10811867 DOI: 10.1186/s13040-024-00354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Nowadays, the chance of discovering the best antibody candidates for predicting clinical malaria has notably increased due to the availability of multi-sera data. The analysis of these data is typically divided into a feature selection phase followed by a predictive one where several models are constructed for predicting the outcome of interest. A key question in the analysis is to determine which antibodies should be included in the predictive stage and whether they should be included in the original or a transformed scale (i.e. binary/dichotomized). METHODS To answer this question, we developed three approaches for antibody selection in the context of predicting clinical malaria: (i) a basic and simple approach based on selecting antibodies via the nonparametric Mann-Whitney-Wilcoxon test; (ii) an optimal dychotomizationdichotomization approach where each antibody was selected according to the optimal cut-off via maximization of the chi-squared (χ2) statistic for two-way tables; (iii) a hybrid parametric/non-parametric approach that integrates Box-Cox transformation followed by a t-test, together with the use of finite mixture models and the Mann-Whitney-Wilcoxon test as a last resort. We illustrated the application of these three approaches with published serological data of 36 Plasmodium falciparum antigens for predicting clinical malaria in 121 Kenyan children. The predictive analysis was based on a Super Learner where predictions from multiple classifiers including the Random Forest were pooled together. RESULTS Our results led to almost similar areas under the Receiver Operating Characteristic curves of 0.72 (95% CI = [0.62, 0.82]), 0.80 (95% CI = [0.71, 0.89]), 0.79 (95% CI = [0.7, 0.88]) for the simple, dichotomization and hybrid approaches, respectively. These approaches were based on 6, 20, and 16 antibodies, respectively. CONCLUSIONS The three feature selection strategies provided a better predictive performance of the outcome when compared to the previous results relying on Random Forest including all the 36 antibodies (AUC = 0.68, 95% CI = [0.57;0.79]). Given the similar predictive performance, we recommended that the three strategies should be used in conjunction in the same data set and selected according to their complexity.
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Affiliation(s)
- André Fonseca
- FCT - Faculdade de Ciências e Tecnologia, Universidade do Algarve, Faro, Portugal
- CEAUL - Centro de Estatística e Aplicações da Universidade de Lisboa, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Mikolaj Spytek
- Faculty of Mathematics & Information Science, Warsaw University of Technology, Warsaw, Poland
| | - Przemysław Biecek
- Faculty of Mathematics & Information Science, Warsaw University of Technology, Warsaw, Poland
| | - Clara Cordeiro
- FCT - Faculdade de Ciências e Tecnologia, Universidade do Algarve, Faro, Portugal
- CEAUL - Centro de Estatística e Aplicações da Universidade de Lisboa, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Nuno Sepúlveda
- CEAUL - Centro de Estatística e Aplicações da Universidade de Lisboa, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.
- Faculty of Mathematics & Information Science, Warsaw University of Technology, Warsaw, Poland.
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Benjamin-Chung J, Li H, Nguyen A, Heitmann GB, Bennett A, Ntuku H, Prach LM, Tambo M, Wu L, Drakeley C, Gosling R, Mumbengegwi D, Kleinschmidt I, Smith JL, Hubbard A, van der Laan M, Hsiang MS. Targeted malaria elimination interventions reduce Plasmodium falciparum infections up to 3 kilometers away. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.19.23295806. [PMID: 37790419 PMCID: PMC10543053 DOI: 10.1101/2023.09.19.23295806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Malaria elimination interventions in low-transmission settings aim to extinguish hot spots and prevent transmission to nearby areas. In malaria elimination settings, the World Health Organization recommends reactive, focal interventions targeted to the area near malaria cases shortly after they are detected. A key question is whether these interventions reduce transmission to nearby uninfected or asymptomatic individuals who did not receive interventions. Here, we measured direct effects (among intervention recipients) and spillover effects (among non-recipients) of reactive, focal interventions delivered within 500m of confirmed malaria index cases in a cluster-randomized trial in Namibia. The trial delivered malaria chemoprevention (artemether lumefantrine) and vector control (indoor residual spraying with Actellic) separately and in combination using a factorial design. We compared incidence, infection prevalence, and seroprevalence between study arms among intervention recipients (direct effects) and non-recipients (spillover effects) up to 3 km away from index cases. We calculated incremental cost-effectiveness ratios accounting for spillover effects. The combined chemoprevention and vector control intervention produced direct effects and spillover effects. In the primary analysis among non-recipients within 1 km from index cases, the combined intervention reduced malaria incidence by 43% (95% CI 20%, 59%). In secondary analyses among non-recipients 500m-3 km from interventions, the combined intervention reduced infection by 79% (6%, 95%) and seroprevalence 34% (20%, 45%). Accounting for spillover effects increased the cost-effectiveness of the combined intervention by 37%. Our findings provide the first evidence that targeting hot spots with combined chemoprevention and vector control interventions can indirectly benefit non-recipients up to 3 km away.
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Affiliation(s)
- Jade Benjamin-Chung
- Department of Epidemiology and Population Health, Stanford University, Stanford, United States
- Chan Zuckerberg Biohub, San Francisco, United States
| | - Haodong Li
- Division of Biostatistics, University of California, Berkeley
| | - Anna Nguyen
- Department of Epidemiology and Population Health, Stanford University, Stanford, United States
| | | | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF) , San Francisco, United States
- PATH, Seattle, United States
| | - Henry Ntuku
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF) , San Francisco, United States
| | - Lisa M. Prach
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF) , San Francisco, United States
| | - Munyaradzi Tambo
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Lindsey Wu
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF) , San Francisco, United States
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Immo Kleinschmidt
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Wits Research Institute for Malaria, Wits/SAMRC Collaborating Centre for Multi-Disciplinary Research on 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
| | - Jennifer L. Smith
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF) , San Francisco, United States
| | - Alan Hubbard
- Division of Biostatistics, University of California, Berkeley
| | | | - Michelle S. Hsiang
- Chan Zuckerberg Biohub, San Francisco, United States
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco (UCSF) , San Francisco, United States
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, United States
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Bérubé S, Kobayashi T, Norris DE, Ruczinski I, Moss WJ, Wesolowski A, Louis TA. Novel bioinformatic methods and machine learning approaches reveal candidate biomarkers of the intensity and timing of past exposure to Plasmodium falciparum. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001840. [PMID: 37531325 PMCID: PMC10395840 DOI: 10.1371/journal.pgph.0001840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/28/2023] [Indexed: 08/04/2023]
Abstract
Accurately quantifying the burden of malaria over time is an important goal of malaria surveillance efforts and can enable effective targeting and evaluation of interventions. Malaria surveillance methods capture active or recent infections which poses several challenges to achieving malaria surveillance goals. In high transmission settings, asymptomatic infections are common and therefore accurate measurement of malaria burden demands active surveillance; in low transmission regions where infections are rare accurate surveillance requires sampling large subsets of the population; and in any context monitoring malaria burden over time necessitates serial sampling. Antibody responses to Plasmodium falciparum parasites persist after infection and therefore measuring antibodies has the potential to overcome several of the current obstacles to accurate malaria surveillance. Identifying which antibody responses are markers of the timing and intensity of past exposure to P. falciparum remains challenging, particularly among adults who tend to be re-exposed multiple times over the course of their lifetime and therefore have similarly high antibody responses to many Plasmodium antigens. A previous analysis of 479 serum samples from individuals in three regions in southern Africa with different historical levels of P. falciparum malaria transmission (high, intermediate, and low) revealed regional differences in antibody responses to P. falciparum antigens among children under 5 years of age. Using a novel bioinformatic pipeline optimized for protein microarrays that minimizes between-sample technical variation, we used antibody responses to Plasmodium antigens as predictors in random forest models to classify samples from adults into these three regions of differing historical malaria transmission with high accuracy (AUC = 0.99). Many of the most important antigens for classification in these models do not overlap with previously published results and are therefore novel candidate markers for the timing and intensity of past exposure to P. falciparum. Measuring antibody responses to these antigens could lead to improved malaria surveillance.
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Affiliation(s)
- Sophie Bérubé
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Tamaki Kobayashi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Douglas E. Norris
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Ingo Ruczinski
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - William J. Moss
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Thomas A. Louis
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Hamre KES, Dismer AM, Rogier E, van den Hoogen LL, Williamson J, Kishore N, Travers A, McGee K, Pierre B, Fouché B, Impoinvil D, Holmes K, Stresman G, Druetz T, Eisele TP, Drakeley C, Lemoine JF, Chang MA. Spatial Clustering and Risk Factors for Malaria Infections and Marker of Recent Exposure to Plasmodium falciparum from a Household Survey in Artibonite, Haiti. Am J Trop Med Hyg 2023; 109:258-272. [PMID: 37277106 PMCID: PMC10397426 DOI: 10.4269/ajtmh.22-0599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 04/12/2023] [Indexed: 06/07/2023] Open
Abstract
Targeting malaria interventions in elimination settings where transmission is heterogeneous is essential to ensure the efficient use of resources. Identifying the most important risk factors among persons experiencing a range of exposure can facilitate such targeting. A cross-sectional household survey was conducted in Artibonite, Haiti, to identify and characterize spatial clustering of malaria infections. Household members (N = 21,813) from 6,962 households were surveyed and tested for malaria. An infection was defined as testing positive for Plasmodium falciparum by either a conventional or novel highly sensitive rapid diagnostic test. Seropositivity to the early transcribed membrane protein 5 antigen 1 represented recent exposure to P. falciparum. Clusters were identified using SaTScan. Associations among individual, household, and environmental risk factors for malaria, recent exposure, and living in spatial clusters of these outcomes were evaluated. Malaria infection was detected in 161 individuals (median age: 15 years). Weighted malaria prevalence was low (0.56%; 95% CI: 0.45-0.70%). Serological evidence of recent exposure was detected in 1,134 individuals. Bed net use, household wealth, and elevation were protective, whereas being febrile, over age 5 years, and living in either households with rudimentary wall material or farther from the road increased the odds of malaria. Two predominant overlapping spatial clusters of infection and recent exposure were identified. Individual, household, and environmental risk factors are associated with the odds of individual risk and recent exposure in Artibonite; spatial clusters are primarily associated with household-level risk factors. Findings from serology testing can further strengthen the targeting of interventions.
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Affiliation(s)
- Karen E. S. Hamre
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | - Amber M. Dismer
- Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lotus L. van den Hoogen
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - John Williamson
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nishant Kishore
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | - Anyess Travers
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | - Kathleen McGee
- Population Services International/Organisation Haïtienne de Marketing Social pour la Santé, Peguy-ville, Haiti
| | - Baby Pierre
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | | | - Daniel Impoinvil
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen Holmes
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gillian Stresman
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Thomas Druetz
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- University of Montreal School of Public Health, Montreal, Canada
| | - Thomas P. Eisele
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Chris Drakeley
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Michelle A. Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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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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7
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Chang MA, Impoinvil D, Hamre KES, Dalexis PE, Mérilien JB, Dismer AM, Fouché B, Desir L, Holmes K, Lafortune W, Herman C, Rogier E, Noland GS, Young AJ, Druetz T, Ashton R, Eisele TP, Cohen J, van den Hoogen L, Stresman G, Drakeley C, Pothin E, Cameron E, Battle KE, Williamson J, Telfort MA, Lemoine JF. Acceptability, Feasibility, Drug Safety, and Effectiveness of a Pilot Mass Drug Administration with a Single Round of Sulfadoxine-Pyrimethamine Plus Primaquine and Indoor Residual Spraying in Communities with Malaria Transmission in Haiti, 2018. Am J Trop Med Hyg 2023; 108:1127-1139. [PMID: 37160282 PMCID: PMC10540127 DOI: 10.4269/ajtmh.22-0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/24/2023] [Indexed: 05/11/2023] Open
Abstract
For a malaria elimination strategy, Haiti's National Malaria Control Program piloted a mass drug administration (MDA) with indoor residual spraying (IRS) in 12 high-transmission areas across five communes after implementing community case management and strengthened surveillance. The MDA distributed sulfadoxine-pyrimethamine and single low-dose primaquine to eligible residents during house visits. The IRS campaign applied pirimiphos-methyl insecticide on walls of eligible houses. Pre- and post-campaign cross-sectional surveys were conducted to assess acceptability, feasibility, drug safety, and effectiveness of the combined interventions. Stated acceptability for MDA before the campaign was 99.2%; MDA coverage estimated at 10 weeks post-campaign was 89.6%. Similarly, stated acceptability of IRS at baseline was 99.9%; however, household IRS coverage was 48.9% because of the high number of ineligible houses. Effectiveness measured by Plasmodium falciparum prevalence at baseline and 10 weeks post-campaign were similar: 1.31% versus 1.43%, respectively. Prevalence of serological markers were similar at 10 weeks post-campaign compared with baseline, and increased at 6 months. No severe adverse events associated with the MDA were identified in the pilot; there were severe adverse events in a separate, subsequent campaign. Both MDA and IRS are acceptable and feasible interventions in Haiti. Although a significant impact of a single round of MDA/IRS on malaria transmission was not found using a standard pre- and post-intervention comparison, it is possible there was blunting of the peak transmission. Seasonal malaria transmission patterns, suboptimal IRS coverage, and low baseline parasitemia may have limited the effectiveness or the ability to measure effectiveness.
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Affiliation(s)
- Michelle A. Chang
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daniel Impoinvil
- Entomology Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Karen E. S. Hamre
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | | | - Jean-Baptiste Mérilien
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Amber M. Dismer
- Emergency Response and Recovery Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Kathleen Holmes
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Willy Lafortune
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Camelia Herman
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Alyssa J. Young
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Thomas Druetz
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Ruth Ashton
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Thomas P. Eisele
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Justin Cohen
- Clinton Health Access Initiative, Washington, District of Columbia
| | | | - Gillian Stresman
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Chris Drakeley
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Emilie Pothin
- Clinton Health Access Initiative, Washington, District of Columbia
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ewan Cameron
- School of Public Health, Curtin University, Bentley, Australia
| | - Katherine E. Battle
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, Washington
| | - John Williamson
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marc-Aurèle Telfort
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
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8
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Rogier EW, Giorgi E, Tetteh K, Sepúlveda N. Editorial: Current research on serological analyses of infectious diseases. Front Med (Lausanne) 2023; 10:1154584. [PMID: 36873877 PMCID: PMC9982155 DOI: 10.3389/fmed.2023.1154584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/19/2023] Open
Affiliation(s)
- Eric William Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Emanuele Giorgi
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Kevin Tetteh
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nuno Sepúlveda
- Department of Mathematics & Information Science, Warsaw University of Technology, Warsaw, Poland.,Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Lisbon, Portugal
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9
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Stresman G, DePina AJ, Nelli L, Monteiro DDS, Leal SDV, Moreira AL, Furtado UD, Roka JCL, Neatherlin J, Gomes C, Tfeil AK, Lindblade KA. Factors related to human-vector contact that modify the likelihood of malaria transmission during a contained Plasmodium falciparum outbreak in Praia, Cabo Verde. FRONTIERS IN EPIDEMIOLOGY 2022; 2:1031230. [PMID: 38455281 PMCID: PMC10910924 DOI: 10.3389/fepid.2022.1031230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/10/2022] [Indexed: 03/09/2024]
Abstract
Background Determining the reproductive rate and how it varies over time and space (RT) provides important insight to understand transmission of a given disease and inform optimal strategies for controlling or eliminating it. Estimating RT for malaria is difficult partly due to the widespread use of interventions and immunity to disease masking incident infections. A malaria outbreak in Praia, Cabo Verde in 2017 provided a unique opportunity to estimate RT directly, providing a proxy for the intensity of vector-human contact and measure the impact of vector control measures. Methods Out of 442 confirmed malaria cases reported in 2017 in Praia, 321 (73%) were geolocated and informed this analysis. RT was calculated using the joint likelihood of transmission between two cases, based on the time (serial interval) and physical distance (spatial interval) between them. Log-linear regression was used to estimate factors associated with changes in RT, including the impact of vector control interventions. A geostatistical model was developed to highlight areas receptive to transmission where vector control activities could be focused in future to prevent or interrupt transmission. Results The RT from individual cases ranged between 0 and 11 with a median serial- and spatial-interval of 34 days [interquartile range (IQR): 17-52] and 1,347 m (IQR: 832-1,985 m), respectively. The number of households receiving indoor residual spraying (IRS) 4 weeks prior was associated with a reduction in RT by 0.84 [95% confidence interval (CI) 0.80-0.89; p-value <0.001] in the peak-and post-epidemic compared to the pre-epidemic period. Conclusions Identifying the effect of reduced human-vector contact through IRS is essential to determining optimal intervention strategies that modify the likelihood of malaria transmission and can inform optimal intervention strategies to accelerate time to elimination. The distance within which two cases are plausibly linked is important for the potential scale of any reactive interventions as well as classifying infections as imported or introduced and confirming malaria elimination.
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Affiliation(s)
- Gillian Stresman
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- College of Public Health, University of South Florida, Tampa, FL, United States
| | | | - Luca Nelli
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | | | - Silvânia da Veiga Leal
- Laboratório de Entomologia Médica, Instituto Nacional de Saúde Pública, Praia, Cabo Verde
| | | | | | | | - John Neatherlin
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States
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10
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Jaramillo-Underwood A, Impoinvil D, Sutcliff A, Hamre KES, Joseph V, van den Hoogen L, Lemoine JF, Ashton RA, Chang MA, Existe A, Boncy J, Drakeley C, Stresman G, Druetz T, Eisele T, Rogier E. Factors Associated With Human IgG Antibody Response to Anopheles albimanus Salivary Gland Extract, Artibonite Department, Haiti, 2017. J Infect Dis 2022; 226:1461-1469. [PMID: 35711005 PMCID: PMC10982684 DOI: 10.1093/infdis/jiac245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/14/2022] [Indexed: 11/14/2022] Open
Abstract
Serological data can provide estimates of human exposure to both malaria vector and parasite based on antibody responses. A multiplex bead-based assay was developed to simultaneously detect IgG to Anopheles albimanus salivary gland extract (SGE) and 23 Plasmodium falciparum antigens among 4185 participants enrolled in Artibonite department, Haiti in 2017. Logistic regression adjusted for participant- and site-level covariates and found children under 5 years and 6-15 years old had 3.7- and 5.4-fold increase in odds, respectively, of high anti-SGE IgG compared to participants >15 years. Seropositivity to P. falciparum CSP, Rh2_2030, and SEA-1 antigens was significantly associated with high IgG response against SGE, and participant enrolment at elevations under 200 m was associated with higher anti-SGE IgG levels. The ability to approximate population exposure to malaria vectors through SGE serology data is very dependent by age categories, and SGE antigens can be easily integrated into a multiplex serological assay.
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Affiliation(s)
- Alicia Jaramillo-Underwood
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daniel Impoinvil
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alice Sutcliff
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Karen E. S. Hamre
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Lotus van den Hoogen
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Ruth A. Ashton
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Michelle A. Chang
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexandre Existe
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Jacques Boncy
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Chris Drakeley
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gillian Stresman
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas Druetz
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, Québec, Canada
| | - Thomas Eisele
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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11
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Rahim MAFA, Chuangchaiya S, Chanpum P, Palawong L, Kantee P, Dian ND, Lubis IND, Divis PCS, Kaneko A, Tetteh KKA, Idris ZM. Seroepidemiological surveillance, community perceptions and associated risk factors of malaria exposure among forest-goers in Northeastern Thailand. Front Cell Infect Microbiol 2022; 12:953585. [PMID: 36093204 PMCID: PMC9450859 DOI: 10.3389/fcimb.2022.953585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 12/02/2022] Open
Abstract
Malaria remains a major public health challenge in Thailand. Continuous assessment and understanding of the behavior and perceptions related to malaria exposure in the high-risk group are necessary to achieve the elimination goal. This study aimed to investigate the parasite prevalence, seroprevalence rate, knowledge, attitudes, and practices (KAP), and malaria risk factors in rural communities living close to a forested area in the northeastern part of Thailand. A community-based cross-sectional survey was conducted in three forest-goer communities (i.e., Ban Khok, Ban Koh, and Dong Yang) located in Khamcha-i district, Mukdahan Province, Thailand, from July to August 2019. Demographic, socioeconomic information and KAP data were collected using a structured questionnaire. Parasite prevalence was determined by microscopy. Seroprevalence was determined via ELISA using two Plasmodium falciparum (PfAMA-1 and PfMSP-119) and two Plasmodium vivax (PvAMA-1 and PvMSP-119) antigens. Age-adjusted antibody responses were analyzed using a reversible catalytic model to calculate seroconversion rate (SCR). Malaria parasite was not detected in any of the 345 participants. The overall malaria seroprevalence was 72.2% for PfAMA-1, 18.8% for PfMSP-119, 32.5% for PvAMA-1, and 4.4% for PvMSP-119. The proportion of seroprevalence for P. falciparum and P. vivax antigens was significantly highest in Ban Koh (35.1%, P < 0.001) and Don Yang (18.8%, P < 0.001), respectively. For all parasite antigens except PvMSP-119, the proportion of seropositive individuals significantly increased with age (P < 0.001). Based on the SCRs, there was a higher level of P. falciparum transmission than P. vivax. Regarding KAP, almost all respondents showed adequate knowledge and awareness about malaria. Nevertheless, significant effort is needed to improve positive attitudes and practices concerning malaria prevention measures. Multivariate regression analyses showed that living in Ban Koh was associated with both P. falciparum (adjusted odds ratio [aOR] 12.87, P < 0.001) and P. vivax (aOR 9.78, P < 0.001) seropositivities. We also found significant associations between age and seropositivity against P. falciparum and P. vivax antigens. The data suggest that seroepidemiological surveillance using AMA-1 and MSP-119 antigens may provide further evidence to reconstruct malaria exposure history. The absence of weak evidence of recent malaria transmission in Mukdahan Province is promising in the context of the disease elimination program.
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Affiliation(s)
- Mohd Amirul Fitri A. Rahim
- Deparment of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sriwipa Chuangchaiya
- Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
- *Correspondence: Zulkarnain Md Idris, ; Sriwipa Chuangchaiya,
| | - Paisit Chanpum
- Vector Borne Disease Unit, Ban Koh Sub-District Health Promoting Hospital, Mukdahan, Thailand
| | - Laun Palawong
- Vector Borne Disease Unit, Ban Koh Sub-District Health Promoting Hospital, Mukdahan, Thailand
| | - Panuwat Kantee
- Vector Borne Disease Unit, Ban Koh Sub-District Health Promoting Hospital, Mukdahan, Thailand
| | - Nor Diyana Dian
- Deparment of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Inke Nadia D. Lubis
- Department of Paediatric, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Paul C. S. Divis
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Akira Kaneko
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Department of Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kevin K. A. Tetteh
- Department of Infection Biology, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zulkarnain Md Idris
- Deparment of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Zulkarnain Md Idris, ; Sriwipa Chuangchaiya,
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12
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Druetz T, van den Hoogen L, Stresman G, Joseph V, Hamre KES, Fayette C, Monestime F, Presume J, Romilus I, Mondélus G, Elismé T, Cooper S, Impoinvil D, Ashton RA, Rogier E, Existe A, Boncy J, Chang MA, Lemoine JF, Drakeley C, Eisele TP. Etramp5 as a useful serological marker in children to assess the immediate effects of mass drug campaigns for malaria. BMC Infect Dis 2022; 22:643. [PMID: 35883064 PMCID: PMC9321307 DOI: 10.1186/s12879-022-07616-8] [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: 03/17/2022] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Serological methods provide useful metrics to estimate age-specific period prevalence in settings of low malaria transmission; however, evidence on the use of seropositivity as an endpoint remains scarce in studies to evaluate combinations of malaria control measures, especially in children. This study aims to evaluate the immediate effects of a targeted mass drug administration campaign (tMDA) in Haiti by using serological markers. METHODS The tMDA was implemented in September-October 2018 using sulfadoxine-pyrimethamine and single low-dose primaquine. A natural quasi-experimental study was designed, using a pretest and posttest in a cohort of 754 randomly selected school children, among which 23% reported having received tMDA. Five antigens were selected as outcomes (MSP1-19, AMA-1, Etramp5 antigen 1, HSP40, and GLURP-R0). Posttest was conducted 2-6 weeks after the intervention. RESULTS At baseline, there was no statistical difference in seroprevalence between the groups of children that were or were not exposed during the posttest. A lower seroprevalence was observed for markers informative of recent exposure (Etramp5 antigen 1, HSP40, and GLURP-R0). Exposure to tMDA was significantly associated with a 50% reduction in the odds of seropositivity for Etramp5 antigen 1 and a 21% reduction in the odds of seropositivity for MSP119. CONCLUSION Serological markers can be used to evaluate the effects of interventions against malaria on the risk of infection in settings of low transmission. Antibody responses against Etramp5 antigen 1 in Haitian children were reduced in the 2-6 weeks following a tMDA campaign, confirming its usefulness as a short-term marker in child populations.
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Affiliation(s)
- T Druetz
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA. .,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada. .,Centre de Recherche en Santé Publique, Montreal, Canada.
| | - L van den Hoogen
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - G Stresman
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - V Joseph
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - K E S Hamre
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA.,CDC Foundation, Atlanta, USA
| | - C Fayette
- IMA World Health, Port-au-Prince, Haiti
| | | | - J Presume
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - I Romilus
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - G Mondélus
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - T Elismé
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - S Cooper
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - D Impoinvil
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA
| | - R A Ashton
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - E Rogier
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA
| | - A Existe
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - J Boncy
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - M A Chang
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA
| | - J F Lemoine
- Programme National de Contrôle du Paludisme, Port-au-Prince, Haiti
| | - C Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - T P Eisele
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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13
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Rogier E, Nace D, Dimbu PR, Wakeman B, Beeson JG, Drakeley C, Tetteh K, Plucinski M. Antibody dynamics in children with first or repeat Plasmodium falciparum infections. Front Med (Lausanne) 2022; 9:869028. [PMID: 35928289 PMCID: PMC9343764 DOI: 10.3389/fmed.2022.869028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Immunoglobulin (Ig) production during and after infection with Plasmodium parasites is one of the greatest adaptive immune defenses the human host has against this parasite. Infection with P. falciparum has been shown to induce different B cell maturation responses dependent upon the age of the patient, number of previous exposures, and severity of the disease. Described here are dynamics of Ig responses to a panel of 32 P. falciparum antigens by patients followed for 42 days and classified individuals as showing characteristics of an apparent first P. falciparum infection (naïve) or a repeat exposure (non-naïve). Six parameters were modeled to characterize the dynamics of IgM, IgG1, IgG3, and IgA for these two exposure groups with differences assessed among Ig isotypes/subclasses and unique antigens. Naïve patients had significantly longer periods of time to reach peak Ig titer (range 4–7 days longer) and lower maximum Ig titers when compared with non-naïve patients. Modeled time to seronegativity was significantly higher in non-naïve patients for IgM and IgA, but not for the two IgG subclasses. IgG1 responses to Rh2030, HSP40, and PfAMA1 were at the highest levels for non-naïve participants and may be used to predict previous or nascent exposure by themselves. The analyses presented here demonstrate the differences in the development of the Ig response to P. falciparum if the infection represents a boosting response or a primary exposure. Consistency in Ig isotype/subclasses estimates and specific data for P. falciparum antigens can better guide interpretation of seroepidemiological data among symptomatic persons.
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Affiliation(s)
- Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
- *Correspondence: Eric Rogier,
| | - Doug Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Brian Wakeman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James G. Beeson
- Burnet Institute, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Chris Drakeley
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kevin Tetteh
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mateusz Plucinski
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
- U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, United States
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14
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Effect of biannual azithromycin distribution on antibody responses to malaria, bacterial, and protozoan pathogens in Niger. Nat Commun 2022; 13:976. [PMID: 35190534 PMCID: PMC8861117 DOI: 10.1038/s41467-022-28565-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 02/02/2022] [Indexed: 11/30/2022] Open
Abstract
The MORDOR trial in Niger, Malawi, and Tanzania found that biannual mass distribution of azithromycin to children younger than 5 years led to a 13.5% reduction in all-cause mortality (NCT02048007). To help elucidate the mechanism for mortality reduction, we report IgG responses to 11 malaria, bacterial, and protozoan pathogens using a multiplex bead assay in pre-specified substudy of 30 communities in the rural Niger placebo-controlled trial over a three-year period (n = 5642 blood specimens, n = 3814 children ages 1–59 months). Mass azithromycin reduces Campylobacter spp. force of infection by 29% (hazard ratio = 0.71, 95% CI: 0.56, 0.89; P = 0.004) but serological measures show no significant differences between groups for other pathogens against a backdrop of high transmission. Results align with a recent microbiome study in the communities. Given significant sequelae of Campylobacter infection among preschool aged children, our results support an important mechanism through which biannual mass distribution of azithromycin likely reduces mortality in Niger. In a randomized placebo-controlled trial in rural Niger, biannual azithromycin distribution to children 1-59 months reduced all-cause mortality. Based on serology, Arzika et al. here report a reduction of Campylobacter infection, supporting one mechanism for the intervention’s impact on mortality.
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15
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Distinct kinetics of antibodies to 111 Plasmodium falciparum proteins identifies markers of recent malaria exposure. Nat Commun 2022; 13:331. [PMID: 35039519 PMCID: PMC8764098 DOI: 10.1038/s41467-021-27863-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 12/15/2021] [Indexed: 11/09/2022] Open
Abstract
Strengthening malaria surveillance is a key intervention needed to reduce the global disease burden. Reliable serological markers of recent malaria exposure could improve current surveillance methods by allowing for accurate estimates of infection incidence from limited data. We studied the IgG antibody response to 111 Plasmodium falciparum proteins in 65 adult travellers followed longitudinally after a natural malaria infection in complete absence of re-exposure. We identified a combination of five serological markers that detect exposure within the previous three months with >80% sensitivity and specificity. Using mathematical modelling, we examined the antibody kinetics and determined that responses informative of recent exposure display several distinct characteristics: rapid initial boosting and decay, less inter-individual variation in response kinetics, and minimal persistence over time. Such serological exposure markers could be incorporated into routine malaria surveillance to guide efforts for malaria control and elimination. Serological markers of recent Plasmodium falciparum infection could be useful to estimate incidence. Here, the authors identify a combination of five serological markers to detect exposure to infection within the previous three months with >80% sensitivity and specificity.
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16
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Druetz T, Stresman G, Ashton RA, Joseph V, van den Hoogen L, Worges M, Hamre KES, Fayette C, Monestime F, Impoinvil D, Rogier E, Chang MA, Lemoine JF, Drakeley C, Eisele TP. The Immediate Effects of a Combined Mass Drug Administration and Indoor Residual Spraying Campaign to Accelerate Progress towards Malaria Elimination in Grande-Anse, Haiti. J Infect Dis 2021; 225:1611-1620. [PMID: 33993294 PMCID: PMC9071345 DOI: 10.1093/infdis/jiab259] [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: 03/09/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Haiti is planning targeted interventions to accelerate progress toward malaria elimination. In the most affected department (Grande-Anse), a combined mass drug administration (MDA) and indoor residual spraying (IRS) campaign was launched in October 2018. This study assessed the intervention’s effectiveness in reducing Plasmodium falciparum prevalence. Methods An ecological quasi-experimental study was designed, using a pretest and posttest with a nonrandomized control group. Surveys were conducted in November 2017 in a panel of easy access groups (25 schools and 16 clinics) and were repeated 2–6 weeks after the campaign, in November 2018. Single-dose sulfadoxine-pyrimethamine and primaquine was used for MDA, and pirimiphos-methyl as insecticide for IRS. Results A total of 10 006 participants were recruited. Fifty-two percent of the population in the intervention area reported having received MDA. Prevalence diminished between 2017 and 2018 in both areas, but the reduction was significantly larger in the intervention area (ratio of adjusted risk ratios, 0.32 [95% confidence interval, .104–.998]). Conclusions Despite a moderate coverage, the campaign was effective in reducing P. falciparum prevalence immediately after 1 round. Targeted MDA plus IRS is useful in preelimination settings to rapidly decrease the parasite reservoir, an encouraging step to accelerate progress toward malaria elimination.
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Affiliation(s)
- Thomas Druetz
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal QC, Canada.,Centre de Recherche en Santé Publique, Montreal QC, Canada
| | - Gillian Stresman
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth A Ashton
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Lotus van den Hoogen
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Matt Worges
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Karen E S Hamre
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA.,CDC Foundation, Atlanta GA, USA
| | | | | | - Daniel Impoinvil
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Michelle A Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population (MSPP), Port-au-Prince, Haiti
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas P Eisele
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
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17
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Rogier E, Nace D, Dimbu PR, Wakeman B, Pohl J, Beeson JG, Drakeley C, Tetteh K, Plucinski M. Framework for Characterizing Longitudinal Antibody Response in Children After Plasmodium falciparum Infection. Front Immunol 2021; 12:617951. [PMID: 33737926 PMCID: PMC7960919 DOI: 10.3389/fimmu.2021.617951] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Human Plasmodium infection produces a robust adaptive immune response. Time courses for 104 children followed for 42 days after initiation of Plasmodium falciparum chemotherapy were assayed for antibody levels to the five isotypes of human immunoglobulins (Ig) and 4 subclasses of IgG for 32 P. falciparum antigens encompassing all 4 parasite stages of human infection. IgD and IgE against these antigens were undetectable at 1:100 serum concentration, but other Ig isotypes and IgG subclasses were consistently observed against all antigens. Five quantitative parameters were developed to directly compare Ig response among isotypes and antigens: Cmax, maximum antibody level; ΔC, difference between Cmax and the antibody level at Day 0; tmax, time in days to reach Cmax; t1/2, Ig signal half-life in days; tneg, estimated number of days until complete loss of Ig signal. Classical Ig patterns for a bloodborne pathogen were seen with IgM showing early tmax and IgG production highest among Ig isotypes. However, some unexpected trends were observed such as IgA showing a biphasic pattern for many antigens. Variability among these dynamics of Ig acquisition and loss was noted for different P. falciparum antigens and able to be compared both quantitatively and statistically. This parametrization methodology allows direct comparison of Ig isotypes produced against various Plasmodium antigens following malaria infection, and the same methodology could be applied to other longitudinal serologic studies from P. falciparum or different pathogens. Specifically for P. falciparum seroepidemiological studies, reliable and quantitative estimates regarding the IgG dynamics in human populations can better optimize modeling efforts for serological outputs.
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Affiliation(s)
- Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Doug Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Brian Wakeman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jan Pohl
- Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James G Beeson
- Burnet Institute, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kevin Tetteh
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mateusz Plucinski
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States.,U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, United States
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18
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Ashton RA, Joseph V, van den Hoogen LL, Tetteh KKA, Stresman G, Worges M, Druetz T, Chang MA, Rogier E, Lemoine JF, Drakeley C, Eisele TP. Risk Factors for Malaria Infection and Seropositivity in the Elimination Area of Grand'Anse, Haiti: A Case-Control Study among Febrile Individuals Seeking Treatment at Public Health Facilities. Am J Trop Med Hyg 2020; 103:767-777. [PMID: 32458784 PMCID: PMC7410432 DOI: 10.4269/ajtmh.20-0097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The island of Hispaniola aims to eliminate malaria by 2025; however, there are limited data to describe epidemiologic risk factors for malaria in this setting. A prospective case–control study was conducted at four health facilities in southwest Haiti, aiming to describe factors influencing the risk of current and past malaria infection. Cases were defined as individuals attending facilities with current or recent fever and positive malaria rapid diagnostic test (RDT), while controls were those with current or recent fever and RDT negative. Serological markers of recent and cumulative exposure to Plasmodium were assessed using the multiplex bead assay from dried blood spots and used for alternate case definitions. Kuldorff’s spatial scan statistic was used to identify local clusters of infection or exposure. Logistic regression models were used to assess potential risk factors for RDT positivity and recent exposure markers, including age-group, gender, and recruiting health facility as group-matching variables. A total of 192 cases (RDT positive) and 915 controls (RDT negative) were recruited. Consistent spatial clusters were identified for all three infection and exposure metrics, indicating temporal stability of malaria transmission at these sites. Risk factors included remoteness from health facilities and household construction, furthermore, insecticide-treated net ownership or use was associated with reduced odds of RDT positivity. These findings indicate the malaria risk in Grand’Anse is driven primarily by location. Travel, occupation, and other behavioral factors were not associated with malaria. These data can support the National Malaria Program to refine and target their intervention approaches, and to move toward elimination.
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Affiliation(s)
- Ruth A Ashton
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Lotus L van den Hoogen
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Kevin K A Tetteh
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gillian Stresman
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matt Worges
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Thomas Druetz
- Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, Canada.,Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Michelle A Chang
- Division of Parasitic Diseases and Malaria, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas P Eisele
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
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