title: Variation in exposure to Anopheles gambiae salivary gland peptide (gSG6-P1) across different malaria transmission settings in the western Kenya highlands.
abstract: BACKGROUND
  The existing metrics of malaria transmission are limited in sensitivity under low transmission intensity. Robust surveillance systems are needed as interventions to monitor reduced transmission and prevention of rapid reintroduction. Serological tools based on antibody responses to parasite and vector antigens are potential tools for transmission measurements. The current study sought to evaluate antibody responses to Anopheles gambiae salivary gland peptide (gSG6- P1), as a biomarker of human exposure to Anopheles bites, in different transmission settings and seasons. The comparison between anti-MSP-1(19) IgG immune responders and non-responders allowed exploring the robustness of the gSG6-P1 peptide as a surveillance tool in an area of decreasing malaria transmission.
  
  
  METHODS
  Total IgG levels to gSG6-P1 were measured in an age-stratified cohort (< 5, 5-14 and ≥ 15 years) in a total of 1,366 participants from three localities in western Kenya [Kisii (hypoendemic), Kakamega (mesoendemic), and Kombewa (hyperendemic)] including 607 sera that were additionally tested for MSP-1(19) specific responses during a low and a high malaria transmission seasons. Antibody prevalence and levels were compared between localities with different transmission intensities. Regression analysis was performed to examine the association between gSG6-P1 and MSP-1(19) seroprevalence and parasite prevalence.
  
  
  RESULTS
  Seroprevalence of gSG6-P1 in the uphill population was 36% while it was 50% valley bottom (χ(2) = 13.2, df = 1, p < 0.001). Median gSG6-P1 antibody levels in the Valley bottom were twice as high as that observed in the uphill population [4.50 vs. 2.05, p < 0.001] and showed seasonal variation. The odds of gSG6-P1 seropositives having MSP-1(19) antibodies were almost three times higher than the odds of seronegatives (OR = 2.87, 95% CI [1.977, 4.176]). The observed parasite prevalence for Kisii, Kakamega and Kombewa were 4%, 19.7% and 44.6% whilst the equivalent gSG6-P1 seroprevalence were 28%, 34% and 54%, respectively.
  
  
  CONCLUSIONS
  The seroprevalence of IgG to gSG6-P1 was sensitive and robust in distinguishing between hypo, meso and hyper transmission settings and seasonal fluctuations.
authors.affiliation: Department of Theoretical and Applied Biology, College of Sciences, Kwame Nkrumah, University of Science & Technology, Kumasi, Ghana. kbadu@noguchi.mimcom.org
authors.forename: Kingsley
authors.initials: K
authors.lastname: Badu
authors.forename: Joram
authors.initials: J
authors.lastname: Siangla
authors.forename: John
authors.initials: J
authors.lastname: Larbi
authors.forename: Bernard W
authors.initials: BW
authors.lastname: Lawson
authors.forename: Yaw
authors.initials: Y
authors.lastname: Afrane
authors.forename: John
authors.initials: J
authors.lastname: Ong'echa
authors.forename: Franck
authors.initials: F
authors.lastname: Remoue
authors.forename: Guofa
authors.initials: G
authors.lastname: Zhou
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Githeko
authors.forename: Guiyun
authors.initials: G
authors.lastname: Yan
mesh_terms: D000818:Animals; D000852:Anopheles / Q000276:immunology* / Q000469:parasitology; D000913:Antibodies, Protozoan / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D062665:Epidemiological Monitoring; D006790:Host-Parasite Interactions / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D019476:Insect Proteins / Q000276:immunology*; D007303:Insect Vectors / Q000276:immunology / Q000469:parasitology; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000276:immunology* / Q000469:parasitology / Q000635:transmission*; D020066:Merozoite Surface Protein 1 / Q000276:immunology; D010963:Plasmodium falciparum / Q000276:immunology; D012471:Salivary Proteins and Peptides / Q000276:immunology*; D012621:Seasons; D016036:Seroepidemiologic Studies
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G; D019476:Insect Proteins; D020066:Merozoite Surface Protein 1; D012471:Salivary Proteins and Peptides