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Author Notes:

Eric Rogier, Email: erogier@cdc.gov

E.R. C.W. L.M.F. A.K. K.M. M.C. K.W. P.J.L and J.F.L. designed the study.

L.D. C.F. A.J and F.M. coordinated the field survey.

E.R. prepared assay reagents and collected laboratory data.

P.J.L and V.U. provided reagents and scientific support.

A.O. and E.R. did the analysis.

A.O. and E.R. prepared the manuscript.

All authors approved the final version of the manuscript.

Blaise Tschirhart, Katie Pendleton, and Divya Sukumar for assistance with sample processing and PET-PCR assays.

The authors declare no competing interests.



  • 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

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

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Journal Title:

Scientific Reports


Volume 10, Number 1


, Pages 8443-8443

Type of Work:

Article | Final Publisher PDF


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.

Copyright information:

© 2020, The Author(s).

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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