Serological evidence for a decline in malaria transmission following major scale-up of control efforts in a setting selected for Plasmodium vivax and Plasmodium falciparum malaria elimination in Babile district, Oromia, Ethiopia. (30th March 2019)

• Record Type: Journal Article
• Authors: Keffale, Migbaru; Shumie, Girma; Behaksra, Sinknesh Wolde; Chali, Wakweya; Hoogen, Lotus L van den; Hailemeskel, Elifaged; Mekonnen, Daniel; Chanyalew, Menberework; Damte, Demekech; Fanta, Tiruwork; Ashine, Temesgen; Chali, Sagni; Tetteh, Kevin K A; Birhanu, Dereje Dillu; Balcha, Taye T; Aseffa, Abraham; Drakeley, Chris; Tessema, Tesfaye S; Adamu, Haileeyesus; Bousema, Teun; Gadisa, Endalamaw; Tadesse, Fitsum G
• Is Part Of: Transactions of the Royal Society of Tropical Medicine and Hygiene. Volume 113:Number 6(2019)
• Page Start: 305
• Page End: 311
• Publication Date: 2019-03-30
• Subjects: current infection -- malaria elimination -- metrics of transmission -- serology; Tropical medicine -- Periodicals; 616.9883
• DOI: 10.1093/trstmh/trz005
• Languages: English
• ISSNs: 0035-9203

Abstract

Abstract: Background: Following successful malaria control during the last decade, Ethiopia instituted a stepwise malaria elimination strategy in selected low-transmission areas. Methods: Cross-sectional surveys were conducted in Babile district, Oromia, Ethiopia from July to November 2017 to evaluate malaria infection status using microscopy and nested polymerase chain reaction (nPCR) and serological markers of exposure targeting Plasmodium falciparum and Plasmodium vivax apical membrane antigen-1 (AMA-1). Results: Parasite prevalence was 1.2% (14/1135) and 5.1% (58/1143) for P. falciparum and 0.4% (5/1135) and 3.6% (41/1143) for P. vivax by microscopy and nPCR, respectively. Antibody prevalence was associated with current infection by nPCR for both P. falciparum (p<0.001) and P. vivax (p=0.014) and showed an age-dependent increase (p<0.001, for both species). Seroconversion curves indicated a decline in malaria exposure 15 y prior to sampling for P. falciparum and 11.5 y prior to sampling for P. vivax, broadly following malaria incidence data from district health offices, with higher antibody titres in adults than children for both species. Conclusions: Malaria transmission declined substantially in the region with continuing heterogeneous but measurable local transmission, arguing in favour of continued and tailored control efforts to accelerate the progress towards elimination efforts.