Estimating medium-and long-term trends in malaria transmission by using serological markers of malaria exposure

CJ Drakeley, PH Corran, PG Coleman… - Proceedings of the …, 2005 - National Acad Sciences
CJ Drakeley, PH Corran, PG Coleman, JE Tongren, SLR McDonald, I Carneiro, R Malima
Proceedings of the National Academy of Sciences, 2005National Acad Sciences
The implementation and evaluation of malaria control programs would be greatly facilitated
by new tools for the rapid assessment of malaria transmission intensity. Because acquisition
and maintenance of antimalarial antibodies depend on exposure to malaria infection, such
antibodies might be used as proxy measures of transmission intensity. We have compared
the prevalence of IgG antibodies with three Plasmodium falciparum asexual stage antigens
in individuals of all ages living at varying altitudes encompassing a range of transmission …
The implementation and evaluation of malaria control programs would be greatly facilitated by new tools for the rapid assessment of malaria transmission intensity. Because acquisition and maintenance of antimalarial antibodies depend on exposure to malaria infection, such antibodies might be used as proxy measures of transmission intensity. We have compared the prevalence of IgG antibodies with three Plasmodium falciparum asexual stage antigens in individuals of all ages living at varying altitudes encompassing a range of transmission intensities from hyper- to hypoendemic in northeastern Tanzania, with alternative measures of transmission intensity. The prevalence of antibodies to merozoite surface protein-119 was significantly more closely correlated with altitude than either point-prevalence malaria parasitemia or single measures of hemoglobin concentration. Analysis of age-specific seroprevalence rates enabled differentiation of recent (seasonal) changes in transmission intensity from longer-term transmission trends and, using a mathematical model of the annual rate of seroconversion, estimation of the longevity of the antibody response. Thus, serological tools allow us to detect variations in malaria transmission over time. Such tools will be invaluable for monitoring trends in malaria endemicity and the effectiveness of malaria control programs.
National Acad Sciences