title: Application of Serological Tools and Spatial Analysis to Investigate Malaria Transmission Dynamics in Highland Areas of Southwest Uganda.
abstract: Serological markers, combined with spatial analysis, offer a comparatively more sensitive means by which to measure and detect foci of malaria transmission in highland areas than traditional malariometric indicators. Plasmodium falciparum parasite prevalence, seroprevalence, and seroconversion rate to P. falciparum merozoite surface protein-119 (MSP-119) were measured in a cross-sectional survey to determine differences in transmission between altitudinal strata. Clusters of P. falciparum parasite prevalence and high antibody responses to MSP-119 were detected and compared. Results show that P. falciparum prevalence and seroprevalence generally decreased with increasing altitude. However, transmission was heterogeneous with hotspots of prevalence and/or seroprevalence detected in both highland and highland fringe altitudes, including a serological hotspot at 2,200 m. Results demonstrate that seroprevalence can be used as an additional tool to identify hotspots of malaria transmission that might be difficult to detect using traditional cross-sectional parasite surveys or through vector studies. Our study findings identify ways in which malaria prevention and control can be more effectively targeted in highland or low transmission areas via serological measures. These tools will become increasingly important for countries with an elimination agenda and/or where malaria transmission is becoming patchy and focal, but receptivity to malaria transmission remains high.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Lynch
authors.forename: Jackie
authors.initials: J
authors.lastname: Cook
authors.forename: Sarah
authors.initials: S
authors.lastname: Nanyunja
authors.forename: Jane
authors.initials: J
authors.lastname: Bruce
authors.forename: Amit
authors.initials: A
authors.lastname: Bhasin
authors.forename: Chris
authors.initials: C
authors.lastname: Drakeley
authors.forename: Cally
authors.initials: C
authors.lastname: Roper
authors.forename: Richard
authors.initials: R
authors.lastname: Pearce
authors.forename: John B
authors.initials: JB
authors.lastname: Rwakimari
authors.forename: Tarekegn A
authors.initials: TA
authors.lastname: Abeku
authors.forename: Patrick
authors.initials: P
authors.lastname: Corran
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cox
mesh_terms: D000293:Adolescent; D000328:Adult; D000531:Altitude; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D012698:Serologic Tests / Q000379:methods*; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult