Combination of Serological, Antigen Detection, and DNA Data for Plasmodium falciparum Provides Robust Geospatial Estimates for Malaria Transmission in Haiti

• Authors: Adan Oviedo, Rollins School of Public Health; Alaine Knipes, Centers for Disease Control and Prevention; Caitlin Worrell, Centers for Disease Control and Prevention; LeAnne Fox, Emory University; Luccene Desir, Carter Center Athens; Carl Fayette, IMA World Health; Alain Javel, IMA World Health; Franck Monestime, IMA World Health; Kimberly Mace, Centers for Disease Control and Prevention; Michelle A. Chang, Centers for Disease Control and Prevention; Venkatachalam Udhayakumar, Centers for Disease Control and Prevention; Jean F. Lemoine, Ministère de la Santé Publique et de la Population; Kimberly Won, Centers for Disease Control and Prevention; Patrick Lammie, Emory University; Eric Rogier, Centers for Disease Control and Prevention
• Journal Title: Scientific Reports
• Volume: Volume 10, Number 1
• Publisher: Nature | 2020-12-01, Pages 8443-8443
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1038/s41598-020-65419-w
• Subjects: Biology, Genetics; Health Sciences, Immunology
• Keywords: Antibodies, Protozoan; Antigens, Protozoan; Child; DNA, Protozoan; Diagnostic Tests, Routine; Female; Geography; Haiti; Humans; Immunologic Tests; Malaria, Falciparum; Male; Plasmodium falciparum; Protozoan Proteins; Spatial Analysis

Abstract

Microscopy is the gold standard for malaria epidemiology, but laboratory and point-of-care (POC) tests detecting parasite antigen, DNA, and human antibodies against malaria have expanded this capacity. The island nation of Haiti is endemic for Plasmodium falciparum (Pf) malaria, though at a low national prevalence and heterogenous geospatial distribution. In 2015 and 2016, serosurveys were performed of children (ages 6–7 years) sampled in schools in Saut d’Eau commune (n = 1,230) and Grand Anse department (n = 1,664) of Haiti. Children received malaria antigen rapid diagnostic test and provided a filter paper blood sample for further laboratory analysis of the Pf histidine-rich protein 2 (HRP2) antigen, Pf DNA, and anti-Pf IgG antibodies. Prevalence of Pf infection ranged from 0.0–16.7% in 53 Saut d’Eau schools, and 0.0–23.8% in 56 Grand Anse schools. Anti-Pf antibody carriage exceeded 80% of students in some schools from both study sites. Geospatial prediction ellipses were created to indicate clustering of positive tests within the survey areas and overlay of all prediction ellipses for the different types of data revealed regions with high likelihood of active and ongoing Pf malaria transmission. The geospatial utilization of different types of Pf data can provide high confidence for spatial epidemiology of the parasite.