1. Geostatistical modeling of malaria endemicity using serological indicators of exposure collected through school surveys.
- Author
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Ashton RA, Kefyalew T, Rand A, Sime H, Assefa A, Mekasha A, Edosa W, Tesfaye G, Cano J, Teka H, Reithinger R, Pullan RL, Drakeley CJ, and Brooker SJ
- Subjects
- Adolescent, Antigens, Protozoan immunology, Bayes Theorem, Child, Child, Preschool, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Ethiopia epidemiology, Humans, Malaria, Falciparum immunology, Malaria, Vivax immunology, Male, Membrane Proteins immunology, Merozoite Surface Protein 1 immunology, Multivariate Analysis, Plasmodium falciparum isolation & purification, Plasmodium vivax isolation & purification, Protozoan Proteins immunology, Schools, Seroepidemiologic Studies, Spatial Analysis, Antibodies, Protozoan immunology, Endemic Diseases statistics & numerical data, Malaria, Falciparum epidemiology, Malaria, Vivax epidemiology, Plasmodium falciparum immunology, Plasmodium vivax immunology
- Abstract
Ethiopia has a diverse ecology and geography resulting in spatial and temporal variation in malaria transmission. Evidence-based strategies are thus needed to monitor transmission intensity and target interventions. A purposive selection of dried blood spots collected during cross-sectional school-based surveys in Oromia Regional State, Ethiopia, were tested for presence of antibodies against Plasmodium falciparum and P. vivax antigens. Spatially explicit binomial models of seroprevalence were created for each species using a Bayesian framework, and used to predict seroprevalence at 5 km resolution across Oromia. School seroprevalence showed a wider prevalence range than microscopy for both P. falciparum (0-50% versus 0-12.7%) and P. vivax (0-53.7% versus 0-4.5%), respectively. The P. falciparum model incorporated environmental predictors and spatial random effects, while P. vivax seroprevalence first-order trends were not adequately explained by environmental variables, and a spatial smoothing model was developed. This is the first demonstration of serological indicators being used to detect large-scale heterogeneity in malaria transmission using samples from cross-sectional school-based surveys. The findings support the incorporation of serological indicators into periodic large-scale surveillance such as Malaria Indicator Surveys, and with particular utility for low transmission and elimination settings., (© The American Society of Tropical Medicine and Hygiene.)
- Published
- 2015
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