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      Serologic Markers for Detecting Malaria in Areas of Low Endemicity, Somalia, 2008

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          Abstract

          These markers can identify spatial variations in transmission patterns.

          Abstract

          Areas in which malaria is not highly endemic are suitable for malaria elimination, but assessing transmission is difficult because of lack of sensitivity of commonly used methods. We evaluated serologic markers for detecting variation in malaria exposure in Somalia. Plasmodium falciparum or P. vivax was not detected by microscopy in cross-sectional surveys of samples from persons during the dry (0/1,178) and wet (0/1,128) seasons. Antibody responses against P. falciparum or P. vivax were detected in 17.9% (179/1,001) and 19.3% (202/1,044) of persons tested. Reactivity against P. falciparum was significantly different between 3 villages (p<0.001); clusters of seroreactivity were present. Distance to the nearest seasonal river was negatively associated with P. falciparum (p = 0.028) and P. vivax seroreactivity (p = 0.016). Serologic markers are a promising tool for detecting spatial variation in malaria exposure and evaluating malaria control efforts in areas where transmission has decreased to levels below the detection limit of microscopy.

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          Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

          Deon Filmer, Lant H. Pritchett (2001)
          Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
          Article 0 comments Cited 1046 times – based on 0 reviews     Review now
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            Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa.

            R W Snow, J A Omumbo, B. Lowe … (1997)
            Malaria remains a major cause of mortality and morbidity in Africa. Many approaches to malaria control involve reducing the chances of infection but little is known of the relations between parasite exposure and the development of effective clinical immunity so the long-term effect of such approaches to control on the pattern and frequency of malaria cannot be predicted. We have prospectively recorded paediatric admissions with severe malaria over three to five years from five discrete communities in The Gambia and Kenya. Demographic analysis of the communities exposed to disease risk allowed the estimation of age-specific rates for severe malaria. Within each community the exposure to Plasmodium falciparum infection was determined through repeated parasitological and serological surveys among children and infants. We used acute respiratory-tract infections (ARI) as a comparison. 3556 malaria admissions were recorded for the five sites. Marked differences were observed in age, clinical spectrum and rates of severe malaria between the five sites. Paradoxically, the risks of severe disease in childhood were lowest among populations with the highest transmission intensities, and the highest disease risks were observed among populations exposed to low-to-moderate intensities of transmission. For severe malaria, for example, admission rates (per 1000 per year) for children up to their 10th birthday were estimated as 3.9, 25.8, 25.9, 16.7, and 18.0 in the five communities; the forces of infection estimated for those communities (new infections per infant per month) were 0.001, 0.034, 0.050, 0.093, and 0.176, respectively. Similar trends were noted for cerebral malaria and for severe malaria anaemia but not for ARI. Mean age of disease decreased with increasing transmission intensity. We propose that a critical determinant of life-time disease risk is the ability to develop clinical immunity early in life during a period when other protective mechanisms may operate. In highly endemic areas measures which reduce parasite transmission, and thus immunity, may lead to a change in both the clinical spectrum of severe disease and the overall burden of severe malaria morbidity.
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              Serology: a robust indicator of malaria transmission intensity?

              Patrick Corran, Paul A. Coleman, Eleanor M. Riley … (2007)
              To estimate the burden of malarial disease, and evaluate the likely effects of control strategies, requires reliable predictions of malaria transmission intensity. It has long been suggested that antimalarial antibody prevalences could provide a more accurate estimate of transmission intensity than traditional measures such as parasite prevalence or entomological inoculation rates, but there has been no systematic evaluation of this approach. Now, the availability of well characterized malarial antigens allows us to test whether serological measurements provide a practical method for estimating transmission. Here we present a suggested methodology, highlight the advantages and shortcomings of serological measurements of malaria transmission and identify areas in which further work is desirable.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): March 2010
                Volume: 16
                Issue: 3
                Pages: 392-399
                Affiliations
                [1]London School of Hygiene and Tropical Medicine, London, UK (T. Bousema, J. Cook, J. Cox, C. Drakeley)
                [2]University of Alexandria, Alexandria, Egypt (R.M. Youssef)
                [3]Kenya Medical Research Institute–Wellcome Trust Research Programme, Nairobi, Kenya (R.M. Youssef, V.A. Alegana, J. Amran, A.M. Noor, R.W. Snow)
                [4]Roll Back Malaria–World Health Organization, Hargeisa, Somalia (J. Amran)
                [5]University of Oxford, Oxford, UK (A.M. Noor, R.W. Snow)
                Author notes
                Address for correspondence: Teun Bousema, Infectious and Tropical Diseases, Immunology Unit, Rm 238C, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK; email: teun.bousema@ 123456lshtm.ac.uk
                Article
                Publisher ID: 09-0732
                DOI: 10.3201/eid1603.090732
                PMC ID: 3322012
                PubMed ID: 20202412
                SO-VID: b24d2478-7998-4318-8b48-d3f608f2d518
                History
                Categories
                Subject: Research
                Subject: Research

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: parasites,research,somalia,transmission,malaria,serology,plasmodium falciparum,plasmodium vivax,immunity,heterogeneity
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: parasites, research, somalia, transmission, malaria, serology, plasmodium falciparum, plasmodium vivax, immunity, heterogeneity

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