Publication: Multiplex serology demonstrate cumulative prevalence and spatial distribution of malaria in Ethiopia
Issued Date
2019-07-22
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ISSN
14752875
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2-s2.0-85069752844
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Mahidol University
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SCOPUS
Bibliographic Citation
Malaria Journal. Vol.18, No.1 (2019)
Suggested Citation
Ashenafi Assefa, Ahmed Ali Ahmed, Wakgari Deressa, Heven Sime, Hussein Mohammed, Amha Kebede, Hiwot Solomon, Hiwot Teka, Kevin Gurrala, Brian Matei, Brian Wakeman, G. Glenn Wilson, Ipsita Sinha, Richard J. Maude, Ruth Ashton, Jackie Cook, Ya Ping Shi, Chris Drakeley, Lorenz Von Seidlein, Eric Rogier, Jimee Hwang Multiplex serology demonstrate cumulative prevalence and spatial distribution of malaria in Ethiopia. Malaria Journal. Vol.18, No.1 (2019). doi:10.1186/s12936-019-2874-z Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51041
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Title
Multiplex serology demonstrate cumulative prevalence and spatial distribution of malaria in Ethiopia
Author(s)
Other Contributor(s)
Federal Ministry of Health - Ethiopia
Addis Ababa University
Harvard T.H. Chan School of Public Health
London School of Hygiene & Tropical Medicine
Centers for Disease Control and Prevention
Tulane University School of Public Health and Tropical Medicine
Syddansk Universitet
Mahidol University
Nuffield Department of Clinical Medicine
United States Agency for International Development
African Society for Laboratory Medicine
Ethiopian Public Health Institute
Addis Ababa University
Harvard T.H. Chan School of Public Health
London School of Hygiene & Tropical Medicine
Centers for Disease Control and Prevention
Tulane University School of Public Health and Tropical Medicine
Syddansk Universitet
Mahidol University
Nuffield Department of Clinical Medicine
United States Agency for International Development
African Society for Laboratory Medicine
Ethiopian Public Health Institute
Abstract
© 2019 The Author(s). Background: Measures of malaria burden using microscopy and rapid diagnostic tests (RDTs) in cross-sectional household surveys may incompletely describe the burden of malaria in low-transmission settings. This study describes the pattern of malaria transmission in Ethiopia using serological antibody estimates derived from a nationwide household survey completed in 2015. Methods: Dried blood spot (DBS) samples were collected during the Ethiopian Malaria Indicator Survey in 2015 from malarious areas across Ethiopia. Samples were analysed using bead-based multiplex assays for IgG antibodies for six Plasmodium antigens: four human malaria species-specific merozoite surface protein-1 19kD antigens (MSP-1) and Apical Membrane Antigen-1 (AMA-1) for Plasmodium falciparum and Plasmodium vivax. Seroprevalence was estimated by age, elevation and region. The seroconversion rate was estimated using a reversible catalytic model fitted with maximum likelihood methods. Results: Of the 10,278 DBS samples available, 93.6% (9622/10,278) had valid serological results. The mean age of participants was 15.8 years and 53.3% were female. National seroprevalence for antibodies to P. falciparum was 32.1% (95% confidence interval (CI) 29.8-34.4) and 25.0% (95% CI 22.7-27.3) to P. vivax. Estimated seroprevalences for Plasmodium malariae and Plasmodium ovale were 8.6% (95% CI 7.6-9.7) and 3.1% (95% CI 2.5-3.8), respectively. For P. falciparum seroprevalence estimates were significantly higher at lower elevations (< 2000 m) compared to higher (2000-2500 m) (aOR 4.4; p < 0.01). Among regions, P. falciparum seroprevalence ranged from 11.0% (95% CI 8.8-13.7) in Somali to 65.0% (95% CI 58.0-71.4) in Gambela Region and for P. vivax from 4.0% (95% CI 2.6-6.2) in Somali to 36.7% (95% CI 30.0-44.1) in Amhara Region. Models fitted to measure seroconversion rates showed variation nationally and by elevation, region, antigen type, and within species. Conclusion: Using multiplex serology assays, this study explored the cumulative malaria burden and regional dynamics of the four human malarias in Ethiopia. High malaria burden was observed in the northwest compared to the east. High transmission in the Gambela and Benishangul-Gumuz Regions and the neglected presence of P. malariae and P. ovale may require programmatic attention. The use of a multiplex assay for antibody detection in low transmission settings has the potential to act as a more sensitive biomarker.