SEROLOGICAL TESTING AND TREATMENT FOR P. VIVAX: FROM A CLUSTER-RANDOMISED TRIAL IN ETHIOPIA AND MADAGASCAR TO A MOBILE-TECHNOLOGY SUPPORTED INTERVENTION

间日疟原虫（P.vivax）被认为是最难消除的人类疟疾，因为常规诊断无法检测出具有潜伏肝脏形式的个体。这些人占所有感染的80%，并且很容易感染蚊子。目前，各国可以测试知道这几乎没有影响或治疗每个人暴露于具有潜在危险副作用的药物。寄生虫特异性抗体反应已被证明与催眠虫携带的可能性相关，并可用于识别应接受治疗的个体。该项目的目的是在埃塞俄比亚和马达加斯加实施一项随机试验，以证明基于间日疟原虫血清学检测和治疗（PvSTATEM）的新型抗疟疾干预措施与伯氨喹的有效性，以预防负责维持间日疟原虫传播的复发感染。与此同时，它将评估社会和卫生系统对这种方法的接受程度，并改进新的移动的技术，这些技术与护理点诊断测试相结合，并指导治疗决定。总体目标是在非洲间日疟原虫感染率最高的两个国家减少个人和人口层面的疟疾负担，以期对降低发病率和改善健康产生重大影响。它将确保社区参与，并评估采用与卫生系统现有技术相一致的新技术的情况。该提案建立在平等伙伴关系和共同能力的基础上，以应对巨大的公共卫生负担。

Plasmodium vivax (P. vivax) is considered the most difficult human malaria to eliminate because of the inability of conventional diagnostics to detect individuals with latent liver forms. These individuals account for 80% of all infections and can readily infect mosquitoes. Currently countries can test knowing this has little impact or treat everyone which exposes individuals to drugs with potentially dangerous side effects. Parasite specific antibody responses have been shown to correlate with the likelihood of hypnozoite carriage and can be used to identify individuals who should be treated. The project aim is to implement a Cluster-Randomised Trial in Ethiopia and Madagascar to demonstrate the effectiveness of a new anti-malaria intervention based on P. vivax serological testing and treatment (PvSTATEM) with primaquine to prevent the relapse infections responsible for maintaining P. vivax transmission. Simultaneously, it will assess social and health system acceptability of such an approach as well as refine new mobile technologies which interface with point-of-care diagnostic tests and guide treatment decisions. The overarching aim to reduce malaria burden at both the individual and population level in two countries which experience the highest levels of P.vivax in Africa with the expectation of having a significant effect in reducing morbidity and improving health. It will ensure community engagement and assess the adoption of new technologies that align with those existing in the health system. The proposal is built on equal partnership and shared capacity to address a substantial public health burden.