Serological Markers Suggest Heterogeneity of Effectiveness of Malaria Control Interventions on Bioko Island, Equatorial Guinea
Serological Markers Suggest Heterogeneity of Effectiveness of Malaria Control Interventions on Bioko Island, Equatorial Guinea
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DOI：
10.1371/journal.pone.0025137
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发表时间：
2011-09-27
期刊：
影响因子：
3.7
通讯作者：
Drakeley, Chris J.
中科院分区：
文献类型：
--
作者：
Cook, Jackie;Kleinschmidt, Immo;Drakeley, Chris J.
背景资料：为了控制和消除疟疾，需要查明正在传播的地区，并有针对性地采取疟疾控制干预措施。在密集的干预措施之后，如果干预措施在某些地区比其他地区更成功，疟疾传播可能会变得更加多样化。赤道几内亚比奥科岛自2004年以来一直受到疟疾控制综合干预措施的影响。这导致了大量减少寄生虫的负担，虽然这种下降并没有统一的island.Methods/Principal调查结果：在2008年，滤纸血液样本收集从7387人在一个横断面研究，将18个哨点比奥科，赤道几内亚。通过酶联免疫吸附试验（ELISA）测量恶性疟原虫顶膜抗原-1（AMA-1）的抗体。使用特定的血清阳性率来估计血清转换率（SCR）。分析表明，岛上五个地区中有四个地区的SCR至少下降了60%。SCR的变化与寄生虫率（PR）的变化以及全因儿童死亡率的区域性降低高度一致。绘制抗AMA-1抗体的平均年龄调整浓度，以确定个体抗体应答高于预期的区域。这种方法证实了西北部的岛屿作为一个主要的重点，持续感染和控制干预措施需要集中或重新evaluated.Conclusion/解释：SCR和PR揭示异质性疟疾传播，并表现出可变的有效性疟疾控制措施。这项工作证实了血清学分析作为监测传播的辅助措施的效用。当没有基线数据时，基于特定血清阳性率的传播随时间变化的证据将特别有价值。重要的是，SCR数据提供了更多的证据，证明疟疾控制活动与全因儿童死亡率的同期下降有关。
Background: In order to control and eliminate malaria, areas of on-going transmission need to be identified and targeted for malaria control interventions. Immediately following intense interventions, malaria transmission can become more heterogeneous if interventions are more successful in some areas than others. Bioko Island, Equatorial Guinea, has been subject to comprehensive malaria control interventions since 2004. This has resulted in substantial reductions in the parasite burden, although this drop has not been uniform across the island.Methods/Principal Findings: In 2008, filter paper blood samples were collected from 7387 people in a cross-sectional study incorporating 18 sentinel sites across Bioko, Equatorial Guinea. Antibodies were measured to P. falciparum Apical Membrane Antigen-1 (AMA-1) by Enzyme Linked Immunosorbent Assay (ELISA). Age-specific seropositivity rates were used to estimate seroconversion rates (SCR). Analysis indicated there had been at least a 60% decline in SCR in four out of five regions on the island. Changes in SCR showed a high degree of congruence with changes in parasite rate (PR) and with regional reductions in all cause child mortality. The mean age adjusted concentration of anti-AMA-1 antibodies was mapped to identify areas where individual antibody responses were higher than expected. This approach confirmed the North West of the island as a major focus of continuing infection and an area where control interventions need to be concentrated or re-evaluated.Conclusion/Interpretation: Both SCR and PR revealed heterogeneity in malaria transmission and demonstrated the variable effectiveness of malaria control measures. This work confirms the utility of serological analysis as an adjunct measure for monitoring transmission. Age-specific seroprevalence based evidence of changes in transmission over time will be of particular value when no baseline data are available. Importantly, SCR data provide additional evidence to link malaria control activities to contemporaneous reductions in all-cause child mortality.