Targeting Asymptomatic Malaria Infections: Active Surveillance in Control and Elimination

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Abstract

Hugh Sturrock and colleagues discuss the role of active case detection in low malaria transmission settings. They argue that the evidence for its effectiveness is sparse and that targeted mass drug administration should be evaluated as an alternative or addition to active case detection.

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Most cited references 54

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A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT).

Chansuda Wongsrichanalai, Mazie Barcus, Sinuon Muth … (2007)

The absolute necessity for rational therapy in the face of rampant drug resistance places increasing importance on the accuracy of malaria diagnosis. Giemsa microscopy and rapid diagnostic tests (RDTs) represent the two diagnostics most likely to have the largest impact on malaria control today. These two methods, each with characteristic strengths and limitations, together represent the best hope for accurate diagnosis as a key component of successful malaria control. This review addresses the quality issues with current malaria diagnostics and presents data from recent rapid diagnostic test trials. Reduction of malaria morbidity and drug resistance intensity plus the associated economic loss of these two factors require urgent scaling up of the quality of parasite-based diagnostic methods. An investment in anti-malarial drug development or malaria vaccine development should be accompanied by a parallel commitment to improve diagnostic tools and their availability to people living in malarious areas.

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A new world malaria map: Plasmodium falciparum endemicity in 2010

Peter W. Gething, Anand P Patil, David Smith … (2012)

Background Transmission intensity affects almost all aspects of malaria epidemiology and the impact of malaria on human populations. Maps of transmission intensity are necessary to identify populations at different levels of risk and to evaluate objectively options for disease control. To remain relevant operationally, such maps must be updated frequently. Following the first global effort to map Plasmodium falciparum malaria endemicity in 2007, this paper describes the generation of a new world map for the year 2010. This analysis is extended to provide the first global estimates of two other metrics of transmission intensity for P. falciparum that underpin contemporary questions in malaria control: the entomological inoculation rate (PfEIR) and the basic reproductive number (PfR). Methods Annual parasite incidence data for 13,449 administrative units in 43 endemic countries were sourced to define the spatial limits of P. falciparum transmission in 2010 and 22,212 P. falciparum parasite rate (PfPR) surveys were used in a model-based geostatistical (MBG) prediction to create a continuous contemporary surface of malaria endemicity within these limits. A suite of transmission models were developed that link PfPR to PfEIR and PfR and these were fitted to field data. These models were combined with the PfPR map to create new global predictions of PfEIR and PfR. All output maps included measured uncertainty. Results An estimated 1.13 and 1.44 billion people worldwide were at risk of unstable and stable P. falciparum malaria, respectively. The majority of the endemic world was predicted with a median PfEIR of less than one and a median PfR c of less than two. Values of either metric exceeding 10 were almost exclusive to Africa. The uncertainty described in both PfEIR and PfR was substantial in regions of intense transmission. Conclusions The year 2010 has a particular significance as an evaluation milestone for malaria global health policy. The maps presented here contribute to a rational basis for control and elimination decisions and can serve as a baseline assessment as the global health community looks ahead to the next series of milestones targeted at 2015.

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Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite.

Ivo Mueller, Mary Galinski, J. Baird … (2009)

Plasmodium vivax is geographically the most widely distributed cause of malaria in people, with up to 2.5 billion people at risk and an estimated 80 million to 300 million clinical cases every year--including severe disease and death. Despite this large burden of disease, P vivax is overlooked and left in the shadow of the enormous problem caused by Plasmodium falciparum in sub-Saharan Africa. The technological advances enabling the sequencing of the P vivax genome and a recent call for worldwide malaria eradication have together placed new emphasis on the importance of addressing P vivax as a major public health problem. However, because of this parasite's biology, it is especially difficult to interrupt the transmission of P vivax, and experts agree that the available methods for preventing and treating infections with P vivax are inadequate. It is thus imperative that the development of new methods and strategies become a priority. Advancing the development of such methods needs renewed emphasis on understanding the biology, pathogenesis, and epidemiology of P vivax. This Review critically examines what is known about P vivax, focusing on identifying the crucial gaps that create obstacles to the elimination of this parasite in human populations.

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Journal

Journal ID (nlm-ta): PLoS Med

Journal ID (iso-abbrev): PLoS Med

Journal ID (publisher-id): PLoS

Journal ID (pmc): plosmed

Title: PLoS Medicine

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Print): 1549-1277

ISSN (Electronic): 1549-1676

Publication date Collection: June 2013

Publication date (Print): June 2013

Publication date (Electronic): 18 June 2013

Volume: 10

Issue: 6

Electronic Location Identifier: e1001467

Affiliations

[1 ]Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, United States of America

[2 ]Department of Pediatrics, University of California, San Francisco, United States of America

[3 ]Clinton Health Access Initiative, Boston, MA, United States of America

[4 ]Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

[5 ]Department of Medicine, University of California, San Francisco, United States of America

[6 ]Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom

[7 ]Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Author notes

* E-mail: sturrockh@ 123456globalhealth.ucsf.edu

The authors have declared that no competing interests exist.

Wrote the first draft of the manuscript: HJWS MSH RDG. Contributed to the writing of the manuscript: HJWS MSH JMC DLS BG TB RDG. ICMJE criteria for authorship read and met: HJWS MSH JMC DLS BG TB RDG. Agree with manuscript’s results and conclusions: HJWS MSH JMC DLS BG TB RDG.

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Publisher ID: PMEDICINE-D-12-03313

DOI: 10.1371/journal.pmed.1001467

PMC ID: 3708701

PubMed ID: 23853551

SO-VID: 7cea42a6-638d-4be1-89de-786902490e49

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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Pages: 8

Funding

HJWS and RDG are supported by a grant from the Bill & Melinda Gates Foundation [#OPP1013170]. MSH is supported by a National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases (NIAID) K23 Award [#P0045532] and a Burroughs Wellcome Fund-American Society of Tropical Medicine and Hygiene Fellowship [#P0049395]. DLS acknowledges support from the Bill & Melinda Gates Foundation [#49446], the RAPIDD Program of the Science & Technology Directorate, Department of Homeland Security, and the Fogarty International Center, National Institutes of Health. BG is supported by a NIH/NIAID K23 Award [#AI076614] and is a recipient of a Doris Duke Clinical Scientist Development Award. DLS and BG are also supported by an International Centers of Excellence in Malaria Research U19 [#AI089674]. TB is supported by a Grand Challenge Grant of the Bill & Melinda Gates Foundation (No. OPP1024438). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Targeting Asymptomatic Malaria Infections: Active Surveillance in Control and Elimination

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Most cited references 54

A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT).

A new world malaria map: Plasmodium falciparum endemicity in 2010

Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite.

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