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Rogier E, Battle N, Bakari C, Seth MD, Nace D, Herman C, Barakoti A, Madebe RA, Mandara CI, Lyimo BM, Giesbrecht DJ, Popkin-Hall ZR, Francis F, Mbwambo D, Garimo I, Aaron S, Lusasi A, Molteni F, Njau R, Cunningham JA, Lazaro S, Mohamed A, Juliano JJ, Bailey JA, Udhayakumar V, Ishengoma DS. Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions among patients enrolled at 100 health facilities throughout Tanzania: February to July 2021. Sci Rep 2024; 14:8158. [PMID: 38589477 PMCID: PMC11001933 DOI: 10.1038/s41598-024-58455-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/29/2024] [Indexed: 04/10/2024] Open
Abstract
Plasmodium falciparum with the histidine rich protein 2 gene (pfhrp2) deleted from its genome can escape diagnosis by HRP2-based rapid diagnostic tests (HRP2-RDTs). The World Health Organization (WHO) recommends switching to a non-HRP2 RDT for P. falciparum clinical case diagnosis when pfhrp2 deletion prevalence causes ≥ 5% of RDTs to return false negative results. Tanzania is a country of heterogenous P. falciparum transmission, with some regions approaching elimination and others at varying levels of control. In concordance with the current recommended WHO pfhrp2 deletion surveillance strategy, 100 health facilities encompassing 10 regions of Tanzania enrolled malaria-suspected patients between February and July 2021. Of 7863 persons of all ages enrolled and providing RDT result and blood sample, 3777 (48.0%) were positive by the national RDT testing for Plasmodium lactate dehydrogenase (pLDH) and/or HRP2. A second RDT testing specifically for the P. falciparum LDH (Pf-pLDH) antigen found 95 persons (2.5% of all RDT positives) were positive, though negative by the national RDT for HRP2, and were selected for pfhrp2 and pfhrp3 (pfhrp2/3) genotyping. Multiplex antigen detection by laboratory bead assay found 135/7847 (1.7%) of all blood samples positive for Plasmodium antigens but very low or no HRP2, and these were selected for genotyping as well. Of the samples selected for genotyping based on RDT or laboratory multiplex result, 158 were P. falciparum DNA positive, and 140 had sufficient DNA to be genotyped for pfhrp2/3. Most of these (125/140) were found to be pfhrp2+/pfhrp3+, with smaller numbers deleted for only pfhrp2 (n = 9) or only pfhrp3 (n = 6). No dual pfhrp2/3 deleted parasites were observed. This survey found that parasites with these gene deletions are rare in Tanzania, and estimated that 0.24% (95% confidence interval: 0.08% to 0.39%) of false-negative HRP2-RDTs for symptomatic persons were due to pfhrp2 deletions in this 2021 Tanzania survey. These data provide evidence for HRP2-based diagnostics as currently accurate for P. falciparum diagnosis in Tanzania.
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Affiliation(s)
- Eric Rogier
- Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Catherine Bakari
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Misago D Seth
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Douglas Nace
- Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Camelia Herman
- Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Achut Barakoti
- Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Rashid A Madebe
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Celine I Mandara
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Beatus M Lyimo
- National Institute for Medical Research, Dar Es Salaam, Tanzania
- Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | | | | | | | | | - Issa Garimo
- National Malaria Control Programme, Dodoma, Tanzania
| | | | | | | | - Ritha Njau
- World Health Organization, Country Office, Dar Es Salaam, Tanzania
| | | | - Samwel Lazaro
- National Malaria Control Programme, Dodoma, Tanzania
| | - Ally Mohamed
- National Malaria Control Programme, Dodoma, Tanzania
| | | | | | | | - Deus S Ishengoma
- National Institute for Medical Research, Dar Es Salaam, Tanzania.
- Faculty of Pharmaceutical Sciences, Monash University, Melbourne, Australia.
- Harvard T.H Chan School of Public Health, Boston, MA, USA.
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Heilmann E, Tembo T, Fwoloshi S, Kabamba B, Chilambe F, Kalenga K, Siwingwa M, Mulube C, Seffren V, Bolton-Moore C, Simwanza J, Yingst S, Yadav R, Rogier E, Auld AF, Agolory S, Kapina M, Gutman JR, Savory T, Kangale C, Mulenga LB, Sikazwe I, Hines JZ. Trends in SARS-CoV-2 seroprevalence among pregnant women attending first antenatal care visits in Zambia: A repeated cross-sectional survey, 2021-2022. PLOS Glob Public Health 2024; 4:e0003073. [PMID: 38568905 PMCID: PMC10990173 DOI: 10.1371/journal.pgph.0003073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024]
Abstract
SARS-CoV-2 serosurveys help estimate the extent of transmission and guide the allocation of COVID-19 vaccines. We measured SARS-CoV-2 seroprevalence among women attending ANC clinics to assess exposure trends over time in Zambia. We conducted repeated cross-sectional SARS-CoV-2 seroprevalence surveys among pregnant women aged 15-49 years attending their first ANC visits in four districts of Zambia (two urban and two rural) during September 2021-September 2022. Serologic testing was done using a multiplex bead assay which detects IgG antibodies to the nucleocapsid protein and the spike protein receptor-binding domain (RBD). We calculated monthly SARS-CoV-2 seroprevalence by district. We also categorized seropositive results as infection alone, infection and vaccination, or vaccination alone based on anti-RBD and anti-nucleocapsid test results and self-reported COVID-19 vaccination status (vaccinated was having received ≥1 dose). Among 8,304 participants, 5,296 (63.8%) were cumulatively seropositive for SARS-CoV-2 antibodies from September 2021 through September 2022. SARS-CoV-2 seroprevalence primarily increased from September 2021 to September 2022 in three districts (Lusaka: 61.8-100.0%, Chongwe: 39.6-94.7%, Chipata: 56.5-95.0%), but in Chadiza, seroprevalence increased from 27.8% in September 2021 to 77.2% in April 2022 before gradually dropping to 56.6% in July 2022. Among 5,906 participants with a valid COVID-19 vaccination status, infection alone accounted for antibody responses in 77.7% (4,590) of participants. Most women attending ANC had evidence of prior SARS-CoV-2 infection and most SARS-CoV-2 seropositivity was infection-induced. Capturing COVID-19 vaccination status and using a multiplex bead assay with anti-nucleocapsid and anti-RBD targets facilitated distinguishing infection-induced versus vaccine-induced antibody responses during a period of increasing COVID-19 vaccine coverage in Zambia. Declining seroprevalence in Chadiza may indicate waning antibodies and a need for booster vaccines. ANC clinics have a potential role in ongoing SARS-CoV-2 serosurveillance and can continue to provide insights into SARS-CoV-2 antibody dynamics to inform near real-time public health responses.
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Affiliation(s)
- Elizabeth Heilmann
- Public Health Institute, Oakland, California, United States of America
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Tannia Tembo
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Sombo Fwoloshi
- Division of Infectious Diseases, Ministry of Health, Lusaka, Zambia
| | | | - Felix Chilambe
- Adult Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | - Kalubi Kalenga
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Mpanji Siwingwa
- Adult Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | | | - Victoria Seffren
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - John Simwanza
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
| | - Samuel Yingst
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Ruchi Yadav
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Andrew F. Auld
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Simon Agolory
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Muzala Kapina
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
| | - Julie R. Gutman
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Theodora Savory
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | - Lloyd B. Mulenga
- Division of Infectious Diseases, Ministry of Health, Lusaka, Zambia
| | - Izukanji Sikazwe
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Jonas Z. Hines
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
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Tenthani L, Seffren V, Kabaghe AN, Ogollah F, Soko M, Yadav R, Kayigamba F, Payne D, Wadonda-Kabondo N, Kampira E, Volkmann T, Sugandhi NS, Seydel K, Rogier E, Thwing JI, Gutman JR. SARS-CoV-2 Seroprevalence and Vaccine Uptake among Pregnant Women at First Antenatal Care Visits in Malawi. Am J Trop Med Hyg 2024:tpmd230726. [PMID: 38531097 DOI: 10.4269/ajtmh.23-0726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/01/2024] [Indexed: 03/28/2024] Open
Abstract
Many SARS-CoV-2 infections are asymptomatic, thus reported cases underestimate actual cases. To improve estimates, we conducted surveillance for SARS-CoV-2 seroprevalence among pregnant women attending their first antenatal care visit (ANC1) from June 2021 through May 2022. We administered a questionnaire to collect demographic, risk factors, and COVID-19 vaccine status information and tested dried blood spots for SARS-CoV-2 antibodies. Although <1% of ANC1 participants reported having had COVID-19, monthly SARS-CoV-2 seroprevalence increased from 15.4% (95% CI: 10.5-21.5) in June 2021 to 65.5% (95% CI: 55.5-73.7) in May 2022. Although COVID-19 vaccination was available in March 2021, uptake remained low, reaching a maximum of 9.5% (95% CI: 5.7-14.8) in May 2022. Results of ANC1 serosurveillance provided prevalence estimates helpful in understanding this population case burden that was available through self-report and national case reports. To improve vaccine uptake, efforts to address fears and misconceptions regarding COVID-19 vaccines are needed.
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Affiliation(s)
- Lyson Tenthani
- ICAP at Columbia University, International Programs - Malawi, Lilongwe, Malawi
| | - Victoria Seffren
- Malaria Branch, Division of Parasitic Diseases and Malaria, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Francis Ogollah
- ICAP at Columbia University, International Programs - Malawi, Lilongwe, Malawi
| | - Monica Soko
- Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Ruchi Yadav
- Malaria Branch, Division of Parasitic Diseases and Malaria, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Felix Kayigamba
- ICAP at Columbia University, International Programs - Malawi, Lilongwe, Malawi
| | - Danielle Payne
- U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi
| | | | | | - Tyson Volkmann
- U.S. President's Malaria Initiative, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi
| | | | - Karl Seydel
- Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Julie I Thwing
- Malaria Branch, Division of Parasitic Diseases and Malaria, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Julie R Gutman
- Malaria Branch, Division of Parasitic Diseases and Malaria, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Sumner KM, Yadav R, Noble EK, Sandford R, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Belongia EA, Chung JR, Rogier E, Coughlin MM, Flannery B. Anti-SARS-CoV-2 Antibody Levels Associated with COVID-19 Protection in Outpatients Tested for SARS-CoV-2, US Flu VE Network, October 2021-June 2022. J Infect Dis 2024:jiae090. [PMID: 38390968 DOI: 10.1093/infdis/jiae090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND We assessed associations between binding antibody (bAb) concentration <5 days of symptom onset and testing positive for COVID-19 among patients in a test-negative study. METHODS From October 2021─June 2022, study sites in seven states enrolled patients aged ≥6 months presenting with acute respiratory illness. Respiratory specimens were tested for SARS-CoV-2. In blood specimens, we measured concentrations of anti-SARS-CoV-2 antibodies against the ancestral strain spike protein receptor binding domain (RBD) and nucleocapsid (N) antigens in standardized binding antibody units (BAU/mL). Percent change in odds of COVID-19 by increasing anti-RBD bAb was estimated using logistic regression as (1-adjusted odds ratio of COVID-19)x100, adjusting for COVID-19 mRNA vaccine doses, age, site, and high-risk exposure. RESULTS Out of 2,018 symptomatic patients, 662 (33%) tested positive for acute SARS-CoV-2 infection. Geometric mean RBD bAb were lower among COVID-19 cases than SARS-CoV-2 test-negative patients during both the Delta-predominant (112 vs. 498 BAU/mL) and Omicron-predominant (823 vs. 1,189 BAU/mL) periods. Acute phase ancestral spike RBD bAb associated with 50% lower odds of COVID-19 were 1,968 BAU/mL against Delta and 3,375 BAU/mL against Omicron; thresholds may differ in other laboratories. CONCLUSION During acute illness, antibody concentrations against ancestral spike RBD were associated with protection against COVID-19.
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Affiliation(s)
- Kelsey M Sumner
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruchi Yadav
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emma K Noble
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Ryan Sandford
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Devyani Joshi
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sara Y Tartof
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Manjusha Gaglani
- Baylor Scott & White Health, Temple, TX, USA
- Baylor College of Medicine - Temple, Temple, TX, USA
- Texas A&M University College of Medicine, Temple, TX, USA
| | | | - H Keipp Talbot
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Jessie R Chung
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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5
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Jaramillo-Underwood A, Herman C, Jean SE, Nace D, Elder ES, Robinson K, Knipes A, Worrell CM, Fox LM, Desir L, Fayette C, Javel A, Monestime F, Mace KE, Udhayakumar V, Won KY, Chang MA, Lemoine JF, Rogier E. Geospatial analysis of Plasmodium falciparum serological indicators: school versus community sampling in a low-transmission malaria setting. BMC Med 2024; 22:31. [PMID: 38254075 PMCID: PMC10804471 DOI: 10.1186/s12916-023-03145-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/31/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Due to low numbers of active infections and persons presenting to health facilities for malaria treatment, case-based surveillance is inefficient for understanding the remaining disease burden in low malaria transmission settings. Serological data through the detection of IgG antibodies from previous malaria parasite exposure can fill this gap by providing a nuanced picture of where sustained transmission remains. Study enrollment at sites of gathering provides a potential approach to spatially estimate malaria exposure and could preclude the need for more intensive community-based sampling. METHODS This study compared spatial estimates of malaria exposure from cross-sectional school- and community-based sampling in Haiti. A total of 52,405 blood samples were collected from 2012 to 2017. Multiplex bead assays (MBAs) tested IgG against P. falciparum liver stage antigen-1 (LSA-1), apical membrane antigen 1 (AMA1), and merozoite surface protein 1 (MSP1). Predictive geospatial models of seropositivity adjusted for environmental covariates, and results were compared using correlations by coordinate points and communes across Haiti. RESULTS Consistent directional associations were observed between seroprevalence and environmental covariates for elevation (negative), air temperature (negative), and travel time to urban centers (positive). Spearman's rank correlation for predicted seroprevalence at coordinate points was lowest for LSA-1 (ρ = 0.10, 95% CI: 0.09-0.11), but improved for AMA1 (ρ = 0.36, 95% CI: 0.35-0.37) and MSP1 (ρ = 0.48, 95% CI: 0.47-0.49). CONCLUSIONS In settings approaching P. falciparum elimination, case-based prevalence data does not provide a resolution of ongoing malaria transmission in the population. Immunogenic antigen targets (e.g., AMA1, MSP1) that give higher population rates of seropositivity provide moderate correlation to gold standard community sampling designs and are a feasible approach to discern foci of residual P. falciparum transmission in an area.
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Affiliation(s)
- Alicia Jaramillo-Underwood
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, 37830, USA
| | - Camelia Herman
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
- CDC Foundation, Atlanta, GA, 30308, USA
| | - Samuel E Jean
- Population Services International, Port-Au-Prince, Haiti
| | - Doug Nace
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - E Scott Elder
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Keri Robinson
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Alaine Knipes
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Caitlin M Worrell
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - LeAnne M Fox
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | | | - Carl Fayette
- IMA World Health, Port-Au-Prince, Haiti
- RTI International, Port-Au-Prince, Haiti
| | - Alain Javel
- IMA World Health, Port-Au-Prince, Haiti
- RTI International, Port-Au-Prince, Haiti
| | | | - Kimberly E Mace
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | | | - Kimberly Y Won
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Michelle A Chang
- US Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jean F Lemoine
- Ministère de La Santé Publique Et de La Population, Port Au Prince, Haiti
| | - Eric Rogier
- Division of Digestive Diseases and Nutrition, University of Kentucky, Lexington, United States.
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6
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Sandford R, Yadav R, Noble EK, Sumner K, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Belongia EA, Carlson C, Coughlin M, Flannery B, Pearce B, Rogier E. Antibody response to symptomatic infection with SARS-CoV-2 Omicron variant viruses, December 2021-June 2022. medRxiv 2023:2023.11.17.23298700. [PMID: 38014151 PMCID: PMC10680903 DOI: 10.1101/2023.11.17.23298700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
To describe humoral immune responses to symptomatic SARS-CoV-2 infection, we assessed immunoglobulin G binding antibody levels using a commercial multiplex bead assay against SARS-CoV-2 ancestral spike protein receptor binding domain (RBD) and nucleocapsid protein (N). We measured binding antibody units per mL (BAU/mL) during acute illness within 5 days of illness onset and during convalescence in 105 ambulatory patients with laboratory-confirmed SARS-CoV-2 infection with Omicron variant viruses. Comparing acute- to convalescent phase antibody concentrations, geometric mean anti-N antibody concentrations increased 47-fold from 5.5 to 259 BAU/mL. Anti-RBD antibody concentrations increased 2.5-fold from 1258 to 3189 BAU/mL.
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7
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Seck MC, Badiane AS, Thwing J, Ndiaye M, Diongue K, Ndiaye IM, Diallo MA, Sy M, Gomis JF, Ndiaye T, Gaye A, Lee YM, Secor WE, Ndiaye D, Rogier E. SEROPREVALENCE TO SCHISTOSOMA SOLUBLE EGG ANTIGEN AMONG NOMADIC PASTORALISTS RESIDING IN NORTHERN SENEGAL. J Parasitol 2023; 109:580-587. [PMID: 38104629 DOI: 10.1645/22-69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Urinary and intestinal schistosomiasis are endemic in Senegal, with prevalence heterogeneous throughout the country. Because of their way of life, nomadic pastoralists are not typically included in epidemiological surveys, and data on the prevalence of schistosomiasis in Senegalese nomadic populations are largely non-existent. The purpose of this study was to determine the seroprevalence of schistosomiasis in Senegalese nomadic pastoralists. A modified snowball sampling survey was conducted among 1,467 nomadic pastoralists aged 6 mo and older in 5 districts in northern Senegal. Dried blood spots from participants of all ages and data regarding demographics were collected to assess IgG antibody responses against Schistosoma mansoni soluble egg antigen (SEA) using a bead-based multiplex assay. Out of 1,467 study subjects, 1,464 (99.8%) provided IgG serological data that cleared quality assurance. Of the participants with appropriate data, 56.6% were male, the median age was 22 yr, and 31.6% were under 15 yr of age. The overall anti-SEA IgG seroprevalence was 19.1% (95% confidence interval [CI]: 17.1-21.1%) with the highest estimates observed in Dagana (35.9%) and the lowest observed in Podor nomadic groups (3.4%). Antibody responses increased significantly with age except for the oldest age groups (>40 yr of age), which saw lower levels of antibody response compared to younger adults. When controlling for age and location by multivariate regression, the male sex was associated with a 2-fold greater odds of anti-SEA IgG seropositivity (aPOR: 2.0; 95% CI: 1.5-2.7). Serosurveys for anti-SEA IgG among nomadic peoples in northern Senegal found a substantial percentage of individuals with evidence for current or previous Schistosoma spp. infection with the highest levels of exposure in the district adjacent to the Diama dam along the Senegal River. With IgG prevalence increased by age except in the older adults, and the male sex significantly associated with seropositivity, these data point toward sex-associated behavioral practices and human environmental modification as risk factors for Schistosoma exposure.
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Affiliation(s)
- Mame Cheikh Seck
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar 16477, Senegal
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Aida Sadikh Badiane
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar 16477, Senegal
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Julie Thwing
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30329
| | - Mouhamadou Ndiaye
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar 16477, Senegal
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Khadim Diongue
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar 16477, Senegal
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Ibrahima Mbaye Ndiaye
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Mamadou Alpha Diallo
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar 16477, Senegal
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Mohamed Sy
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Jules François Gomis
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Tolla Ndiaye
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Aminata Gaye
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Yeuk-Mui Lee
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30329
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30329
| | - Daouda Ndiaye
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar 16477, Senegal
- International Research & Training Center in Applied Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar 16477, Senegal
| | - Eric Rogier
- Current address: Division of Digestive Disease and Nutrition, University of Kentucky, Lexington, Kentucky 40506
- At the time of this work was employed by the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30329
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Sumner KM, Yadav R, Noble EK, Sandford R, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Chung JR, Rogier E, Coughlin MM, Flannery B. Anti-SARS-CoV-2 Antibody Levels Associated with COVID-19 Protection in Outpatients Tested for SARS-CoV-2, US Flu VE Network, October 2021-June 2022. medRxiv 2023:2023.09.21.23295919. [PMID: 37790578 PMCID: PMC10543239 DOI: 10.1101/2023.09.21.23295919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background We assessed the association between antibody concentration ≤5 days of symptom onset and COVID-19 illness among patients enrolled in a test-negative study. Methods From October 2021-June 2022, study sites in seven states enrolled and tested respiratory specimens from patients of all ages presenting with acute respiratory illness for SARS-CoV-2 infection using rRT-PCR. In blood specimens, we measured concentration of anti-SARS-CoV-2 antibodies against the ancestral strain spike protein receptor binding domain (RBD) and nucleocapsid (N) antigens in standardized binding antibody units (BAU/mL). Percent reduction in odds of symptomatic COVID-19 by anti-RBD antibody was estimated using logistic regression modeled as (1-adjusted odds ratio of COVID-19)×100, adjusting for COVID-19 vaccination status, age, site, and high-risk exposure. Results A total of 662 (33%) of 2,018 symptomatic patients tested positive for acute SARS-CoV-2 infection. During the Omicron-predominant period, geometric mean anti-RBD binding antibody concentrations measured 823 BAU/mL (95%CI:690-981) among COVID-19 case-patients versus 1,189 BAU/mL (95%CI:1,050-1,347) among SARS-CoV-2 test-negative patients. In the adjusted logistic regression, increasing levels of anti-RBD antibodies were associated with reduced odds of COVID-19 for both Delta and Omicron infections. Conclusion Higher anti-RBD antibodies in patients were associated with protection against symptomatic COVID-19 during emergence of SARS-CoV-2 Delta and Omicron variants.
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Affiliation(s)
- Kelsey M. Sumner
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruchi Yadav
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emma K. Noble
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Ryan Sandford
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Devyani Joshi
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sara Y. Tartof
- Kaiser Permanente Southern California, Department of Research & Evaluation
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Karen J. Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Manjusha Gaglani
- Baylor Scott & White Health, Temple, TX, USA
- Texas A&M University College of Medicine, Temple, TX, USA
| | | | | | | | - Jessie R. Chung
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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9
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Leonard CM, Uhomoibhi P, Abubakar A, Ogunniyi A, Mba N, Greby SM, Okoye MI, Iriemenam NC, Ihekweazu C, Steinhardt L, Rogier E. Dynamics of IgG antibody response against Plasmodium antigens among Nigerian infants and young children. Front Immunol 2023; 14:1208822. [PMID: 37691957 PMCID: PMC10484571 DOI: 10.3389/fimmu.2023.1208822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/24/2023] [Indexed: 09/12/2023] Open
Abstract
Background Plasmodium falciparum malaria is a leading cause of child mortality in Nigeria. Neonates are born with maternal antibodies from placental transfer which may protect against malaria infection in the first months of life. The IgG dynamics of the transition from passively transferred antimalarial antibodies to actively acquired IgG from natural exposure have not been well elucidated. Methods Blood samples collected during a 2018 Nigeria nationwide HIV/AIDS household survey were available for 9,443 children under 5 years of age, with a subset of infants under 2 months of age having maternal samples available (n=41). Samples were assayed for the P. falciparum HRP2 antigen and anti-malarial IgG antibodies. LOESS regression examined the dynamics in IgG response in the first 5 years of life. Correlation with maternal IgG levels was assessed for mother/child pairs. Results Consistent decreases were observed in median IgG levels against all Plasmodium spp. antigen targets for the first months of life. At a population level, P. falciparum apical membrane antigen-1 (AMA1) and merozoite surface protein-1 19kD (PfMSP1) IgG decreased during the first 12 months of life before reaching a nadir, whereas IgGs to other targets only declined for the first 4 months of life. Seropositivity showed a similar decline with the lowest seropositivity against AMA1 and PfMSP1 at 10-12 months, though remaining above 50% during the first 2 years of life in higher transmission areas. No protective association was observed between IgG positivity and P. falciparum infection in infants. Maternal antibody levels showed a strong positive correlation with infant antibody levels for all P. falciparum antigens from birth to 2 months of age, but this correlation was lost by 6 months of age. Discussion Maternally transferred anti-malarial IgG antibodies rapidly decline during the first 6 months of life, with variations among specific antigens and malaria transmission intensity. From 3-23 months of age, there was a wide range in IgG levels for the blood-stage antigens indicating high individual variation in antibody production as children are infected with malaria. Non-falciparum species-specific antigens showed similar patterns in waning immunity and correlation with paired mother's IgG levels compared to P. falciparum antigens.
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Affiliation(s)
- Colleen M. Leonard
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
- Oak Ridge Institute for Science and Education, U.S. Department of Energy, Oak Ridge, TN, United States
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Ado Abubakar
- Institute of Human Virology (IHVN), Abuja, Nigeria
| | | | - Nwando Mba
- Nigeria Centre for Disease Control (NCDC), Abuja, Nigeria
| | - Stacie M. Greby
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - McPaul I. Okoye
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nnaemeka C. Iriemenam
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | | | - Laura Steinhardt
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - NMS4 Technical Working Group
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
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10
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Hamre KES, Dismer AM, Rogier E, van den Hoogen LL, Williamson J, Kishore N, Travers A, McGee K, Pierre B, Fouché B, Impoinvil D, Holmes K, Stresman G, Druetz T, Eisele TP, Drakeley C, Lemoine JF, Chang MA. Spatial Clustering and Risk Factors for Malaria Infections and Marker of Recent Exposure to Plasmodium falciparum from a Household Survey in Artibonite, Haiti. Am J Trop Med Hyg 2023; 109:258-272. [PMID: 37277106 PMCID: PMC10397426 DOI: 10.4269/ajtmh.22-0599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 04/12/2023] [Indexed: 06/07/2023] Open
Abstract
Targeting malaria interventions in elimination settings where transmission is heterogeneous is essential to ensure the efficient use of resources. Identifying the most important risk factors among persons experiencing a range of exposure can facilitate such targeting. A cross-sectional household survey was conducted in Artibonite, Haiti, to identify and characterize spatial clustering of malaria infections. Household members (N = 21,813) from 6,962 households were surveyed and tested for malaria. An infection was defined as testing positive for Plasmodium falciparum by either a conventional or novel highly sensitive rapid diagnostic test. Seropositivity to the early transcribed membrane protein 5 antigen 1 represented recent exposure to P. falciparum. Clusters were identified using SaTScan. Associations among individual, household, and environmental risk factors for malaria, recent exposure, and living in spatial clusters of these outcomes were evaluated. Malaria infection was detected in 161 individuals (median age: 15 years). Weighted malaria prevalence was low (0.56%; 95% CI: 0.45-0.70%). Serological evidence of recent exposure was detected in 1,134 individuals. Bed net use, household wealth, and elevation were protective, whereas being febrile, over age 5 years, and living in either households with rudimentary wall material or farther from the road increased the odds of malaria. Two predominant overlapping spatial clusters of infection and recent exposure were identified. Individual, household, and environmental risk factors are associated with the odds of individual risk and recent exposure in Artibonite; spatial clusters are primarily associated with household-level risk factors. Findings from serology testing can further strengthen the targeting of interventions.
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Affiliation(s)
- Karen E. S. Hamre
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | - Amber M. Dismer
- Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lotus L. van den Hoogen
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - John Williamson
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nishant Kishore
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | - Anyess Travers
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | - Kathleen McGee
- Population Services International/Organisation Haïtienne de Marketing Social pour la Santé, Peguy-ville, Haiti
| | - Baby Pierre
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | | | - Daniel Impoinvil
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen Holmes
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gillian Stresman
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Thomas Druetz
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- University of Montreal School of Public Health, Montreal, Canada
| | - Thomas P. Eisele
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Chris Drakeley
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Michelle A. Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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11
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Diallo AO, Banek K, Kashamuka MM, Bala JAM, Nkalani M, Kihuma G, Nseka TM, Atibu JL, Mahilu GE, McCormick L, White SJ, Sendor R, Sinai C, Keeler C, Herman C, Emch M, Sompwe E, Thwai KL, Dinglasan RR, Rogier E, Juliano JJ, Tshefu AK, Parr JB. Impact of malaria diagnostic choice on monitoring of Plasmodium falciparum prevalence estimates in the Democratic Republic of the Congo and relevance to control programs in high-burden countries. PLOS Glob Public Health 2023; 3:e0001375. [PMID: 37494361 PMCID: PMC10370698 DOI: 10.1371/journal.pgph.0001375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/09/2023] [Indexed: 07/28/2023]
Abstract
Malaria programs rely upon a variety of diagnostic assays, including rapid diagnostic tests (RDTs), microscopy, polymerase chain reaction (PCR), and bead-based immunoassays (BBA), to monitor malaria prevalence and support control and elimination efforts. Data comparing these assays are limited, especially from high-burden countries like the Democratic Republic of the Congo (DRC). Using cross-sectional and routine data, we compared diagnostic performance and Plasmodium falciparum prevalence estimates across health areas of varying transmission intensity to illustrate the relevance of assay performance to malaria control programs. Data and samples were collected between March-June 2018 during a cross-sectional household survey across three health areas with low, moderate, and high transmission intensities within Kinshasa Province, DRC. Samples from 1,431 participants were evaluated using RDT, microscopy, PCR, and BBA. P. falciparum parasite prevalence varied between diagnostic methods across all health areas, with the highest prevalence estimates observed in Bu (57.4-72.4% across assays), followed by Kimpoko (32.6-53.2%), and Voix du Peuple (3.1-8.4%). Using latent class analysis to compare these diagnostic methods against an "alloyed gold standard," the most sensitive diagnostic method was BBA in Bu (high prevalence) and Voix du Peuple (low prevalence), while PCR diagnosis was most sensitive in Kimpoko (moderate prevalence). RDTs were consistently the most specific diagnostic method in all health areas. Among 9.0 million people residing in Kinshasa Province in 2018, the estimated P. falciparum prevalence by microscopy, PCR, and BBA were nearly double that of RDT. Comparison of malaria RDT, microscopy, PCR, and BBA results confirmed differences in sensitivity and specificity that varied by endemicity, with PCR and BBA performing best for detecting any P. falciparum infection. Prevalence estimates varied widely depending on assay type for parasite detection. Inherent differences in assay performance should be carefully considered when using community survey and surveillance data to guide policy decisions.
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Affiliation(s)
- Alpha Oumar Diallo
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Kristin Banek
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | | | | | - Marthe Nkalani
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Georges Kihuma
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Tommy Mambulu Nseka
- Programme National de Lutte Contre Paludisme, Kinshasa, Democratic Republic of the Congo
| | - Joseph Losoma Atibu
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Georges Emo Mahilu
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Lauren McCormick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Samuel J. White
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Rachel Sendor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Cyrus Sinai
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Corinna Keeler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Camelia Herman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Michael Emch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Eric Sompwe
- Programme National de Lutte Contre Paludisme, Kinshasa, Democratic Republic of the Congo
| | - Kyaw Lay Thwai
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Rhoel R. Dinglasan
- University of Florida Emerging Pathogens Institute, Department of Infectious Diseases & Immunology, College of Veterinary Medicine, Gainesville, Florida, United States of America
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jonathan J. Juliano
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Antoinette Kitoto Tshefu
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jonathan B. Parr
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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12
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da Silva C, Boene S, Datta D, Rovira-Vallbona E, Aranda-Díaz A, Cisteró P, Hathaway N, Tessema S, Chidimatembue A, Matambisso G, Nhama A, Macete E, Pujol A, Nhamussua L, Galatas B, Guinovart C, Enosse S, De Carvalho E, Rogier E, Plucinski MM, Colborn J, Zulliger R, Saifodine A, Alonso PL, Candrinho B, Greenhouse B, Aide P, Saute F, Mayor A. Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique. Commun Biol 2023; 6:619. [PMID: 37291425 PMCID: PMC10250372 DOI: 10.1038/s42003-023-04997-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/30/2023] [Indexed: 06/10/2023] Open
Abstract
Mozambique is one of the four African countries which account for over half of all malaria deaths worldwide, yet little is known about the parasite genetic structure in that country. We performed P. falciparum amplicon and whole genome sequencing on 2251 malaria-infected blood samples collected in 2015 and 2018 in seven provinces of Mozambique to genotype antimalarial resistance markers and interrogate parasite population structure using genome-wide microhaplotyes. Here we show that the only resistance-associated markers observed at frequencies above 5% were pfmdr1-184F (59%), pfdhfr-51I/59 R/108 N (99%) and pfdhps-437G/540E (89%). The frequency of pfdhfr/pfdhps quintuple mutants associated with sulfadoxine-pyrimethamine resistance increased from 80% in 2015 to 89% in 2018 (p < 0.001), with a lower expected heterozygosity and higher relatedness of microhaplotypes surrounding pfdhps mutants than wild-type parasites suggestive of recent selection. pfdhfr/pfdhps quintuple mutants also increased from 72% in the north to 95% in the south (2018; p < 0.001). This resistance gradient was accompanied by a concentration of mutations at pfdhps-436 (17%) in the north, a south-to-north increase in the genetic complexity of P. falciparum infections (p = 0.001) and a microhaplotype signature of regional differentiation. The parasite population structure identified here offers insights to guide antimalarial interventions and epidemiological surveys.
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Affiliation(s)
- Clemente da Silva
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Simone Boene
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Debayan Datta
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Andrés Aranda-Díaz
- EPPIcenter Research Program, Division of HIV, ID, and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Pau Cisteró
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Sofonias Tessema
- EPPIcenter Research Program, Division of HIV, ID, and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | | | - Glória Matambisso
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Abel Nhama
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Eusebio Macete
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Arnau Pujol
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Lidia Nhamussua
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Beatriz Galatas
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Sónia Enosse
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Eva De Carvalho
- World Health Organization, WHO Country Office Maputo, Maputo, Mozambique
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mateusz M Plucinski
- United States President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James Colborn
- Clinton Health Access Initiative, Maputo, Mozambique
| | - Rose Zulliger
- U.S. President's Malaria Initiative, USAID, Washington, DC, USA
| | | | - Pedro L Alonso
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Hospital Clinic-Universitat de Barcelona, Barcelona, Spain
| | - Baltazar Candrinho
- National Malaria Control Programme, Ministry of Health, Maputo, Mozambique
| | - Bryan Greenhouse
- EPPIcenter Research Program, Division of HIV, ID, and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Pedro Aide
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Francisco Saute
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Alfredo Mayor
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- Department of Physiologic Sciences, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique.
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13
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Chang MA, Impoinvil D, Hamre KES, Dalexis PE, Mérilien JB, Dismer AM, Fouché B, Desir L, Holmes K, Lafortune W, Herman C, Rogier E, Noland GS, Young AJ, Druetz T, Ashton R, Eisele TP, Cohen J, van den Hoogen L, Stresman G, Drakeley C, Pothin E, Cameron E, Battle KE, Williamson J, Telfort MA, Lemoine JF. Acceptability, Feasibility, Drug Safety, and Effectiveness of a Pilot Mass Drug Administration with a Single Round of Sulfadoxine-Pyrimethamine Plus Primaquine and Indoor Residual Spraying in Communities with Malaria Transmission in Haiti, 2018. Am J Trop Med Hyg 2023; 108:1127-1139. [PMID: 37160282 PMCID: PMC10540127 DOI: 10.4269/ajtmh.22-0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/24/2023] [Indexed: 05/11/2023] Open
Abstract
For a malaria elimination strategy, Haiti's National Malaria Control Program piloted a mass drug administration (MDA) with indoor residual spraying (IRS) in 12 high-transmission areas across five communes after implementing community case management and strengthened surveillance. The MDA distributed sulfadoxine-pyrimethamine and single low-dose primaquine to eligible residents during house visits. The IRS campaign applied pirimiphos-methyl insecticide on walls of eligible houses. Pre- and post-campaign cross-sectional surveys were conducted to assess acceptability, feasibility, drug safety, and effectiveness of the combined interventions. Stated acceptability for MDA before the campaign was 99.2%; MDA coverage estimated at 10 weeks post-campaign was 89.6%. Similarly, stated acceptability of IRS at baseline was 99.9%; however, household IRS coverage was 48.9% because of the high number of ineligible houses. Effectiveness measured by Plasmodium falciparum prevalence at baseline and 10 weeks post-campaign were similar: 1.31% versus 1.43%, respectively. Prevalence of serological markers were similar at 10 weeks post-campaign compared with baseline, and increased at 6 months. No severe adverse events associated with the MDA were identified in the pilot; there were severe adverse events in a separate, subsequent campaign. Both MDA and IRS are acceptable and feasible interventions in Haiti. Although a significant impact of a single round of MDA/IRS on malaria transmission was not found using a standard pre- and post-intervention comparison, it is possible there was blunting of the peak transmission. Seasonal malaria transmission patterns, suboptimal IRS coverage, and low baseline parasitemia may have limited the effectiveness or the ability to measure effectiveness.
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Affiliation(s)
- Michelle A. Chang
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daniel Impoinvil
- Entomology Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Karen E. S. Hamre
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
- CDC Foundation, Atlanta, Georgia
| | | | - Jean-Baptiste Mérilien
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Amber M. Dismer
- Emergency Response and Recovery Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Kathleen Holmes
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Willy Lafortune
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Camelia Herman
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Alyssa J. Young
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Thomas Druetz
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Ruth Ashton
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Thomas P. Eisele
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Justin Cohen
- Clinton Health Access Initiative, Washington, District of Columbia
| | | | - Gillian Stresman
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Chris Drakeley
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Emilie Pothin
- Clinton Health Access Initiative, Washington, District of Columbia
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ewan Cameron
- School of Public Health, Curtin University, Bentley, Australia
| | - Katherine E. Battle
- Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, Washington
| | - John Williamson
- Malaria Branch, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marc-Aurèle Telfort
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
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14
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Chang MA, Fouché B, LaFortune W, Holmes K, Rigodon J, Juin S, Marseille S, Rogier E, Green M, Kheradmand T, Moore SG, Gaul DA, Boncy J, Telfort MA. Investigation of Four Cases of Stevens-Johnson Syndrome among Participants in a Mass Drug Administration Campaign with Sulfadoxine-Pyrimethamine and Primaquine in Haiti, 2020. Am J Trop Med Hyg 2023; 108:1140-1144. [PMID: 37127264 PMCID: PMC10540108 DOI: 10.4269/ajtmh.22-0625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/26/2023] [Indexed: 05/03/2023] Open
Abstract
In 2018, a mass drug administration (MDA) campaign for malaria elimination was piloted in Haiti. The pilot treated 36,338 people with sulfadoxine-pyrimethamine (SP) and primaquine; no severe adverse events were detected. In 2020, another MDA campaign using the same medications was implemented to mitigate an upsurge in malaria cases during the COVID-19 pandemic. Four cases of Stevens-Johnson syndrome (SJS) were identified among the 42,249 people who took the medications. Three of these individuals required hospitalization; all survived. In addition to SP ingestion, an investigation of potential causes for increased SJS cases identified that all four cases had human leukocyte antigens A*29 and/or B*44:03, another known risk factor for SJS. Additionally, three of the four case individuals had antibodies to SARS-CoV-2, and the fourth may have been exposed around the same time. These findings raise the possibility that recent SARS-CoV-2 infection may have contributed to the increased risk for SJS associated with SP exposure during the 2020 campaign.
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Affiliation(s)
- Michelle A. Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Willy LaFortune
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Kathleen Holmes
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jonas Rigodon
- CDC-Haiti, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Port-au-Prince, Haiti
| | - Stanley Juin
- CDC-Haiti, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Port-au-Prince, Haiti
| | - Samson Marseille
- Laboratoire National de la Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael Green
- Entomology Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Taba Kheradmand
- Fred H. Allen Immunogenetics Laboratory, New York Blood Center, New York, New York
| | - Samuel G. Moore
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
| | - David A. Gaul
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia
| | - Jacques Boncy
- Laboratoire National de la Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Marc-Aurele Telfort
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
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15
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Herman C, Leonard CM, Uhomoibhi P, Maire M, Moss D, Inyang U, Abubakar A, Ogunniyi A, Mba N, Greby SM, Okoye MI, Iriemenam NC, Maikore I, Steinhardt L, Rogier E. Non-falciparum malaria infection and IgG seroprevalence among children under 15 years in Nigeria, 2018. Nat Commun 2023; 14:1360. [PMID: 36914649 PMCID: PMC10011577 DOI: 10.1038/s41467-023-37010-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
Plasmodium falciparum (Pf) is the dominant malaria parasite in Nigeria though P. vivax (Pv), P. ovale (Po), and P. malariae (Pm) are also endemic. Blood samples (n = 31,234) were collected from children aged 0-14 years during a 2018 nationwide HIV survey and assayed for Plasmodium antigenemia, Plasmodium DNA, and IgG against Plasmodium MSP1-19 antigens. Of all children, 6.6% were estimated to have Pm infection and 1.4% Po infection with no Pv infections detected. The highest household wealth quintile was strongly protective against infection with Pm (aOR: 0.11, 95% CI: 0.05-0.22) or Po (aOR= 0.01, 0.00-0.10). Overall Pm seroprevalence was 34.2% (95% CI: 33.3-35.2) with lower estimates for Po (12.1%, 11.6-12.5) and Pv (6.3%, 6.0-6.7). Pm seropositivity was detected throughout the country with several local government areas showing >50% seroprevalence. Serological and DNA indicators show widespread exposure of Nigerian children to Pm with lower rates to Po and Pv.
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Affiliation(s)
- Camelia Herman
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.,BeVera Solutions, Atlanta, GA, 30341, USA
| | - Colleen M Leonard
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.,Oak Ridge Institute for Science and Education, US. Department of Energy, Oak Ridge, TN, 37831, USA
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Mark Maire
- U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Delynn Moss
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Uwem Inyang
- U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Abuja, Nigeria
| | - Ado Abubakar
- Institute of Human Virology (IHVN), Abuja, Nigeria
| | | | - Nwando Mba
- Nigeria Centre for Disease Control (NCDC), Abuja, Nigeria
| | - Stacie M Greby
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - McPaul I Okoye
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nnaemeka C Iriemenam
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Ibrahim Maikore
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Laura Steinhardt
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.
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16
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Dyal J, Kofman A, Kollie JZ, Fankhauser J, Orone R, Soka MJ, Glaybo U, Kiawu A, Freeman E, Giah G, Tony HD, Faikai M, Jawara M, Kamara K, Kamara S, Flowers B, Kromah ML, Desamu-Thorpe R, Graziano J, Brown S, Morales-Betoulle ME, Cannon DL, Su K, Linderman SL, Plucinski M, Rogier E, Bradbury RS, Secor WE, Bowden KE, Phillips C, Carrington MN, Park YH, Martin MP, Aguinaga MDP, Mushi R, Haberling DL, Ervin ED, Klena JD, Massaquoi M, Nyenswah T, Nichol ST, Chiriboga DE, Williams DE, Hinrichs SH, Ahmed R, Vonhm BT, Rollin PE, Purpura LJ, Choi MJ. Risk Factors for Ebola Virus Persistence in Semen of Survivors in Liberia. Clin Infect Dis 2023; 76:e849-e856. [PMID: 35639875 PMCID: PMC10169428 DOI: 10.1093/cid/ciac424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/08/2022] [Accepted: 05/24/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Long-term persistence of Ebola virus (EBOV) in immunologically privileged sites has been implicated in recent outbreaks of Ebola virus disease (EVD) in Guinea and the Democratic Republic of Congo. This study was designed to understand how the acute course of EVD, convalescence, and host immune and genetic factors may play a role in prolonged viral persistence in semen. METHODS A cohort of 131 male EVD survivors in Liberia were enrolled in a case-case study. "Early clearers" were defined as those with 2 consecutive negative EBOV semen test results by real-time reverse-transcription polymerase chain reaction (rRT-PCR) ≥2 weeks apart within 1 year after discharge from the Ebola treatment unit or acute EVD. "Late clearers" had detectable EBOV RNA by rRT-PCR >1 year after discharge from the Ebola treatment unit or acute EVD. Retrospective histories of their EVD clinical course were collected by questionnaire, followed by complete physical examinations and blood work. RESULTS Compared with early clearers, late clearers were older (median, 42.5 years; P < .001) and experienced fewer severe clinical symptoms (median 2, P = .006). Late clearers had more lens opacifications (odds ratio, 3.9 [95% confidence interval, 1.1-13.3]; P = .03), after accounting for age, higher total serum immunoglobulin G3 (IgG3) titers (P = .005), and increased expression of the HLA-C*03:04 allele (0.14 [.02-.70]; P = .007). CONCLUSIONS Older age, decreased illness severity, elevated total serum IgG3 and HLA-C*03:04 allele expression may be risk factors for the persistence of EBOV in the semen of EVD survivors. EBOV persistence in semen may also be associated with its persistence in other immunologically protected sites, such as the eye.
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Affiliation(s)
- Jonathan Dyal
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aaron Kofman
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Romeo Orone
- ELWA Hospital, Samaritan's Purse, Monrovia, Liberia
| | - Moses J Soka
- ELWA Hospital, Samaritan's Purse, Monrovia, Liberia
| | - Uriah Glaybo
- Men's Health Screening Program, Monrovia, Liberia
| | - Armah Kiawu
- Men's Health Screening Program, Monrovia, Liberia
| | - Edna Freeman
- Men's Health Screening Program, Monrovia, Liberia
| | | | - Henry D Tony
- Men's Health Screening Program, Monrovia, Liberia
| | | | - Mary Jawara
- Men's Health Screening Program, Monrovia, Liberia
| | - Kuku Kamara
- Men's Health Screening Program, Monrovia, Liberia
| | | | | | | | - Rodel Desamu-Thorpe
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James Graziano
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shelley Brown
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria E Morales-Betoulle
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Deborah L Cannon
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kaihong Su
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | - Mateusz Plucinski
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard S Bradbury
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine E Bowden
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christi Phillips
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary N Carrington
- Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, Maryland, USA.,Laboratory of Integrative Cancer Immunology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.,Ragon Institute of MGH, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA
| | - Yeon-Hwa Park
- Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, Maryland, USA
| | - Maureen P Martin
- Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, Maryland, USA
| | - Maria Del Pilar Aguinaga
- Department of Internal Medicine, Meharry Sickle Cell Center, Meharry Medical College, Nashville, Tennessee, USA.,Department of Obstetrics and Gynecology, Meharry Sickle Cell Center, Nashville, Tennessee, USA
| | - Robert Mushi
- Department of Internal Medicine, Meharry Sickle Cell Center, Meharry Medical College, Nashville, Tennessee, USA
| | - Dana L Haberling
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth D Ervin
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John D Klena
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Stuart T Nichol
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David E Chiriboga
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Desmond E Williams
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Steven H Hinrichs
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Rafi Ahmed
- Emory Vaccine Center, Emory University, Atlanta, Georgia, USA
| | | | - Pierre E Rollin
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lawrence J Purpura
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary J Choi
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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17
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Oviedo A, Abubakar A, Uhomoibhi P, Maire M, Inyang U, Audu B, Iriemenam NC, Ogunniyi A, Ssekitooleko J, Kalambo JA, Greby SM, Mba N, Swaminathan M, Ihekweazu C, Okoye MI, Rogier E, Steinhardt LC. Plasmodium falciparum infection prevalence among children aged 6-59 months from independent DHS and HIV surveys: Nigeria, 2018. Sci Rep 2023; 13:1998. [PMID: 36737630 PMCID: PMC9898257 DOI: 10.1038/s41598-023-28257-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Prevalence estimates are critical for malaria programming efforts but generating these from non-malaria surveys is not standard practice. Malaria prevalence estimates for 6-59-month-old Nigerian children were compared between two national household surveys performed simultaneously in 2018: a Demographic and Health Survey (DHS) and the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). DHS tested via microscopy (n = 8298) and HRP2-based rapid diagnostic test (RDT, n = 11,351), and NAIIS collected dried blood spots (DBS) which were later tested for histidine-rich protein 2 (HRP2) antigen (n = 8029). National Plasmodium falciparum prevalence was 22.6% (95% CI 21.2- 24.1%) via microscopy and 36.2% (34.6- 37.8%) via RDT according to DHS, and HRP2 antigenemia was 38.3% (36.7-39.9%) by NAIIS DBS. Between the two surveys, significant rank-order correlation occurred for state-level malaria prevalence for RDT (Rho = 0.80, p < 0.001) and microscopy (Rho = 0.75, p < 0.001) versus HRP2. RDT versus HRP2 positivity showed 24 states (64.9%) with overlapping 95% confidence intervals from the two independent surveys. P. falciparum prevalence estimates among 6-59-month-olds in Nigeria were highly concordant from two simultaneous, independently conducted household surveys, regardless of malaria test utilized. This provides evidence for the value of post-hoc laboratory HRP2 detection to leverage non-malaria surveys with similar sampling designs to obtain accurate P. falciparum estimates.
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Affiliation(s)
- Adan Oviedo
- Malaria Branch, Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA
| | - Ado Abubakar
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Mark Maire
- US President's Malaria Initiative, Abuja, Nigeria
| | - Uwem Inyang
- United States Agency for International Development, Abuja, Nigeria
| | - Bala Audu
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Nnaemeka C Iriemenam
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Abuja, FCT, Nigeria
| | | | - James Ssekitooleko
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | - Jo-Angeline Kalambo
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | - Stacie M Greby
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Abuja, FCT, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Mahesh Swaminathan
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Abuja, FCT, Nigeria
| | | | - McPaul I Okoye
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Abuja, FCT, Nigeria
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA
| | - Laura C Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.
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18
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Iriemenam NC, Ige FA, Greby SM, Okunoye OO, Uwandu M, Aniedobe M, Nwaiwu SO, Mba N, Okoli M, William NE, Ehoche A, Mpamugo A, Mitchell A, Stafford KA, Thomas AN, Olaleye T, Akinmulero OO, Agala NP, Abubakar AG, Owens A, Gwyn SE, Rogier E, Udhayakumar V, Steinhardt LC, Martin DL, Okoye MI, Audu R. Comparison of one single-antigen assay and three multi-antigen SARS-CoV-2 IgG assays in Nigeria. J Clin Virol Plus 2023; 3:100139. [PMID: 36683611 PMCID: PMC9837382 DOI: 10.1016/j.jcvp.2023.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/03/2022] [Accepted: 01/12/2023] [Indexed: 01/14/2023] Open
Abstract
Objectives Determining an accurate estimate of SARS-CoV-2 seroprevalence has been challenging in African countries where malaria and other pathogens are endemic. We compared the performance of one single-antigen assay and three multi-antigen SARS-CoV-2 IgG assays in a Nigerian population endemic for malaria. Methods De-identified plasma specimens from SARS-CoV-2 RT-PCR positive, dried blood spot (DBS) SARS-CoV-2 RT-PCR positive, and pre-pandemic negatives were used to evaluate the performance of the four SARS-CoV-2 assays (Tetracore, SARS2MBA, RightSign, xMAP). Results Results showed higher sensitivity with the multi-antigen (81% (Tetracore), 96% (SARS2MBA), 85% (xMAP)) versus the single-antigen (RightSign (64%)) SARS-CoV-2 assay. The overall specificities were 98% (Tetracore), 100% (SARS2MBA and RightSign), and 99% (xMAP). When stratified based on <15 days to ≥15 days post-RT-PCR confirmation, the sensitivities increased from 75% to 88.2% for Tetracore; from 93% to 100% for the SARS2MBA; from 58% to 73% for RightSign; and from 83% to 88% for xMAP. With DBS, there was no positive increase after 15-28 days for the three assays (Tetracore, SARS2MBA, and xMAP). Conclusion Multi-antigen assays performed well in Nigeria, even with samples with known malaria reactivity, and might provide more accurate measures of COVID-19 seroprevalence and vaccine efficacy.
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Affiliation(s)
- Nnaemeka C Iriemenam
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Fehintola A Ige
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Stacie M Greby
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Olumide O Okunoye
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Mabel Uwandu
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Maureen Aniedobe
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Stephnie O Nwaiwu
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control (NCDC), Gaduwa, FCT, Nigeria
| | - Mary Okoli
- Nigeria Centre for Disease Control (NCDC), Gaduwa, FCT, Nigeria
| | | | - Akipu Ehoche
- University of Maryland Center for International Health, Education, and Biosecurity (CIHEB), Maryland Global Initiatives Corporation (MGIC), FCT, Nigeria
| | - Augustine Mpamugo
- University of Maryland Center for International Health, Education, and Biosecurity (CIHEB), Maryland Global Initiatives Corporation (MGIC), FCT, Nigeria
| | - Andrew Mitchell
- Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Kristen A Stafford
- Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Andrew N Thomas
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Temitope Olaleye
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Oluwaseun O Akinmulero
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Ndidi P Agala
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Ado G Abubakar
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Ajile Owens
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah E Gwyn
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Venkatachalam Udhayakumar
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura C Steinhardt
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Diana L Martin
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - McPaul I Okoye
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Rosemary Audu
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
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19
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Rogier E, Bakari C, Mandara CI, Chiduo MG, Plucinski M, Nace D, Battle N, Chacky F, Rumisha SF, Molteni F, Mandike R, Mkude S, Njau R, Mohamed A, Udhayakumar V, Ishengoma DS. Performance of antigen detection for HRP2-based malaria rapid diagnostic tests in community surveys: Tanzania, July-November 2017. Malar J 2022; 21:361. [PMID: 36457087 PMCID: PMC9714097 DOI: 10.1186/s12936-022-04383-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/12/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Malaria rapid diagnostic tests (RDTs) based on the detection of the Plasmodium falciparum histidine-rich protein 2 (HRP2) antigen are widely used for detection of active infection with this parasite and are the only practical malaria diagnostic test in some endemic settings. External validation of RDT results from field surveys can confirm appropriate RDT performance. METHODS A community-based cross-sectional survey was conducted between July and November 2017 enrolling participants of all ages in households from 15 villages in four border regions of Tanzania: Geita, Kigoma, Mtwara and Ruvuma. All participants had an RDT performed in the field and provided a blood sample for later laboratory multiplex antigen detection of HRP2. In assessing the continuous HRP2 levels in participant blood versus RDT result, dose-response logistic regression provided quantitative estimates for HRP2 limit of detection (LOD). RESULTS From the 15 study villages, 6941 persons were enrolled that had a RDT at time of enrollment and provided a DBS for later laboratory antigen detection. RDT positive prevalence for the HRP2 band by village ranged from 20.0 to 43.6%, but the magnitude of this prevalence did not have an effect on the estimated LOD of RDTs utilized in different villages. Overall, HRP2 single-target tests had a lower LOD at the 95% probability of positive RDT (4.3 ng/mL; 95% CI 3.4-5.4) when compared to pLDH/HRP2 dual target tests (5.4 ng/mL; 4.5-6.3), though this difference was not significant. With the exception of one village, all other 14 villages (93.3%) showed RDT LOD estimates at 90% probability of positive RDT between 0.5 and 12.0 ng/mL. CONCLUSIONS Both HRP2-only and pLDH/HRP2 combo RDTs utilized in a 2017 Tanzania cross-sectional survey of border regions generally performed well, and reliably detected HRP2 antigen in the low ng/mL range. Though single target tests had lower levels of HRP2 detection, both tests were within similar ranges among the 15 villages. Comparison of quantitative HRP2 detection limits among study sites can help interpret RDT testing results when generating population prevalence estimates for malaria infection.
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Affiliation(s)
- Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.
| | - Catherine Bakari
- grid.416716.30000 0004 0367 5636National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Celine I. Mandara
- grid.416716.30000 0004 0367 5636National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Mercy G. Chiduo
- grid.416716.30000 0004 0367 5636National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Mateusz Plucinski
- grid.416738.f0000 0001 2163 0069Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA 30029 USA
| | - Douglas Nace
- grid.416738.f0000 0001 2163 0069Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA 30029 USA
| | - Nastassia Battle
- grid.416738.f0000 0001 2163 0069Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA 30029 USA ,grid.474959.20000 0004 0528 628XCDC Foundation, Atlanta, GA USA
| | - Franky Chacky
- grid.415734.00000 0001 2185 2147National Malaria Control Programme, Dodoma, Tanzania
| | - Susan F. Rumisha
- grid.416716.30000 0004 0367 5636National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania ,grid.414659.b0000 0000 8828 1230Malaria Atlas Project, Geospatial Health and Development, Telethon Kids Institute, Perth, WA Australia
| | | | - Renata Mandike
- grid.415734.00000 0001 2185 2147National Malaria Control Programme, Dodoma, Tanzania
| | - Sigsbert Mkude
- grid.415734.00000 0001 2185 2147National Malaria Control Programme, Dodoma, Tanzania
| | - Ritha Njau
- World Health Organization Country Office, Dar es Salaam, Tanzania
| | - Ally Mohamed
- grid.415734.00000 0001 2185 2147National Malaria Control Programme, Dodoma, Tanzania
| | - Venkatachalam Udhayakumar
- grid.416738.f0000 0001 2163 0069Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA 30029 USA
| | - Deus S. Ishengoma
- grid.416716.30000 0004 0367 5636National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania ,grid.38142.3c000000041936754XHarvard T.H Chan School of Public Health, Boston, MA USA ,grid.1002.30000 0004 1936 7857Faculty of Pharmaceutical Sciences, Monash University, Melbourne, Australia
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20
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Jaramillo-Underwood A, Herman C, Impoinvil D, Sutcliff A, Knipes A, Worrell CM, Fox LM, Desir L, Fayette C, Javel A, Monestime F, Mace KE, Chang MA, Lemoine JF, Won K, Udhayakumar V, Rogier E. Spatial, environmental, and individual associations with Anopheles albimanus salivary antigen IgG in Haitian children. Front Cell Infect Microbiol 2022; 12:1033917. [DOI: 10.3389/fcimb.2022.1033917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
IgG serology can be utilized to estimate exposure to Anopheline malaria vectors and the Plasmodium species they transmit. A multiplex bead-based assay simultaneously detected IgG to Anopheles albimanus salivary gland extract (SGE) and four Plasmodium falciparum antigens (CSP, LSA-1, PfAMA1, and PfMSP1) in 11,541 children enrolled at 350 schools across Haiti in 2016. Logistic regression estimated odds of an above-median anti-SGE IgG response adjusting for individual- and environmental-level covariates. Spatial analysis detected statistically significant clusters of schools with students having high anti-SGE IgG levels, and spatial interpolation estimated anti-SGE IgG levels in unsampled locations. Boys had 11% (95% CI: 0.81, 0.98) lower odds of high anti-SGE IgG compared to girls, and children seropositive for PfMSP1 had 53% (95% CI: 1.17, 2.00) higher odds compared to PfMSP1 seronegatives. Compared to the lowest elevation, quartiles 2-4 of higher elevation were associated with successively lower odds (0.81, 0.43, and 0.34, respectively) of high anti-SGE IgG. Seven significant clusters of schools were detected in Haiti, while spatially interpolated results provided a comprehensive picture of anti-SGE IgG levels in the study area. Exposure to malaria vectors by IgG serology with SGE is a proxy to approximate vector biting in children and identify risk factors for vector exposure.
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21
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Jaramillo-Underwood A, Impoinvil D, Sutcliff A, Hamre KES, Joseph V, van den Hoogen L, Lemoine JF, Ashton RA, Chang MA, Existe A, Boncy J, Drakeley C, Stresman G, Druetz T, Eisele T, Rogier E. Factors Associated With Human IgG Antibody Response to Anopheles albimanus Salivary Gland Extract, Artibonite Department, Haiti, 2017. J Infect Dis 2022; 226:1461-1469. [PMID: 35711005 PMCID: PMC10982684 DOI: 10.1093/infdis/jiac245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/14/2022] [Indexed: 11/14/2022] Open
Abstract
Serological data can provide estimates of human exposure to both malaria vector and parasite based on antibody responses. A multiplex bead-based assay was developed to simultaneously detect IgG to Anopheles albimanus salivary gland extract (SGE) and 23 Plasmodium falciparum antigens among 4185 participants enrolled in Artibonite department, Haiti in 2017. Logistic regression adjusted for participant- and site-level covariates and found children under 5 years and 6-15 years old had 3.7- and 5.4-fold increase in odds, respectively, of high anti-SGE IgG compared to participants >15 years. Seropositivity to P. falciparum CSP, Rh2_2030, and SEA-1 antigens was significantly associated with high IgG response against SGE, and participant enrolment at elevations under 200 m was associated with higher anti-SGE IgG levels. The ability to approximate population exposure to malaria vectors through SGE serology data is very dependent by age categories, and SGE antigens can be easily integrated into a multiplex serological assay.
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Affiliation(s)
- Alicia Jaramillo-Underwood
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daniel Impoinvil
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alice Sutcliff
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Karen E. S. Hamre
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Lotus van den Hoogen
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Ruth A. Ashton
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Michelle A. Chang
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexandre Existe
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Jacques Boncy
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Chris Drakeley
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gillian Stresman
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas Druetz
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, Québec, Canada
| | - Thomas Eisele
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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22
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Rogier E, McCaffery JN, Mohamed MA, Herman C, Nace D, Daniels R, Lucchi N, Jones S, Goldman I, Aidoo M, Cheng Q, Kemenang EA, Udhayakumar V, Cunningham J. Plasmodium falciparum pfhrp2 and pfhrp3 Gene Deletions and Relatedness to Other Global Isolates, Djibouti, 2019-2020. Emerg Infect Dis 2022; 28:2043-2050. [PMID: 36148905 PMCID: PMC9514350 DOI: 10.3201/eid2810.220695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Deletions of pfhrp2 and paralogue pfhrp3 (pfhrp2/3) genes threaten Plasmodium falciparum diagnosis by rapid diagnostic test. We examined 1,002 samples from suspected malaria patients in Djibouti City, Djibouti, to investigate pfhrp2/3 deletions. We performed assays for Plasmodium antigen carriage, pfhrp2/3 genotyping, and sequencing for 7 neutral microsatellites to assess relatedness. By PCR assay, 311 (31.0%) samples tested positive for P. falciparum infection, and 296 (95.2%) were successfully genotyped; 37 (12.5%) samples were pfhrp2+/pfhrp3+, 51 (17.2%) were pfhrp2+/pfhrp3-, 5 (1.7%) were pfhrp2-/pfhrp3+, and 203 (68.6%) were pfhrp2-/pfhrp3-. Histidine-rich protein 2/3 antigen concentrations were reduced with corresponding gene deletions. Djibouti P. falciparum is closely related to Ethiopia and Eritrea parasites (pairwise GST 0.68 [Ethiopia] and 0.77 [Eritrea]). P. falciparum with deletions in pfhrp2/3 genes were highly prevalent in Djibouti City in 2019-2020; they appear to have arisen de novo within the Horn of Africa and have not been imported.
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23
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Badiane A, Thwing J, Williamson J, Rogier E, Diallo MA, Ndiaye D. Sensitivity and specificity for malaria classification of febrile persons by rapid diagnostic test, microscopy, parasite DNA, histidine-rich protein 2, and IgG: Dakar, Senegal 2015. Int J Infect Dis 2022; 121:92-97. [PMID: 35504551 PMCID: PMC10948003 DOI: 10.1016/j.ijid.2022.04.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Different methods for detecting Plasmodium parasite infection or exposure are available, but a systematic comparison of all these methodologies to predict malaria infection is lacking. Understanding the characteristics of respective tests is helpful in choosing the most appropriate tests for epidemiological or research purposes. METHODS We performed microscopy, rapid diagnostic tests (RDTs), and polymerase chain reaction (PCR) for 496 patients presenting with febrile illness in Dakar, Senegal, in 2015. Blood samples had laboratory multiplex assays performed for Immunoglobin G serology and detection of histidine-rich protein 2 (HRP2) antigen. Sensitivity (Se) and specificity (Sp) for different tests were calculated using PCR as the gold standard for detecting active infection. Modeling through latent class analysis compared each test to a modeled gold standard for Se/Sp estimates. RESULTS Against PCR, Se/Sp were 95.2%/93.7% for RDT, 90.4%/100.0% for microscopy, and 97.9%/48.1% for laboratory HRP2 detection. Compared with the modeled gold standard, Se of microscopy was 93.5% and Se of RDT, PCR, and laboratory HRP2 detection were all greater than 99%. Se/Sp of Immunoglobin G serology were substantially lower for detecting active infection. CONCLUSIONS Compared with single tests, a combinatorial latent class analysis approach of multiple biomarkers for detecting malaria infection from patient samples provides greater sensitivity and specificity for epidemiological estimates and research objectives.
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Affiliation(s)
| | - Julie Thwing
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA.
| | - John Williamson
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA
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24
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Druetz T, van den Hoogen L, Stresman G, Joseph V, Hamre KES, Fayette C, Monestime F, Presume J, Romilus I, Mondélus G, Elismé T, Cooper S, Impoinvil D, Ashton RA, Rogier E, Existe A, Boncy J, Chang MA, Lemoine JF, Drakeley C, Eisele TP. Etramp5 as a useful serological marker in children to assess the immediate effects of mass drug campaigns for malaria. BMC Infect Dis 2022; 22:643. [PMID: 35883064 PMCID: PMC9321307 DOI: 10.1186/s12879-022-07616-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Serological methods provide useful metrics to estimate age-specific period prevalence in settings of low malaria transmission; however, evidence on the use of seropositivity as an endpoint remains scarce in studies to evaluate combinations of malaria control measures, especially in children. This study aims to evaluate the immediate effects of a targeted mass drug administration campaign (tMDA) in Haiti by using serological markers. METHODS The tMDA was implemented in September-October 2018 using sulfadoxine-pyrimethamine and single low-dose primaquine. A natural quasi-experimental study was designed, using a pretest and posttest in a cohort of 754 randomly selected school children, among which 23% reported having received tMDA. Five antigens were selected as outcomes (MSP1-19, AMA-1, Etramp5 antigen 1, HSP40, and GLURP-R0). Posttest was conducted 2-6 weeks after the intervention. RESULTS At baseline, there was no statistical difference in seroprevalence between the groups of children that were or were not exposed during the posttest. A lower seroprevalence was observed for markers informative of recent exposure (Etramp5 antigen 1, HSP40, and GLURP-R0). Exposure to tMDA was significantly associated with a 50% reduction in the odds of seropositivity for Etramp5 antigen 1 and a 21% reduction in the odds of seropositivity for MSP119. CONCLUSION Serological markers can be used to evaluate the effects of interventions against malaria on the risk of infection in settings of low transmission. Antibody responses against Etramp5 antigen 1 in Haitian children were reduced in the 2-6 weeks following a tMDA campaign, confirming its usefulness as a short-term marker in child populations.
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Affiliation(s)
- T Druetz
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA. .,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada. .,Centre de Recherche en Santé Publique, Montreal, Canada.
| | - L van den Hoogen
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - G Stresman
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - V Joseph
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - K E S Hamre
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA.,CDC Foundation, Atlanta, USA
| | - C Fayette
- IMA World Health, Port-au-Prince, Haiti
| | | | - J Presume
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - I Romilus
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - G Mondélus
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - T Elismé
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - S Cooper
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - D Impoinvil
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA
| | - R A Ashton
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - E Rogier
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA
| | - A Existe
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - J Boncy
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - M A Chang
- Malaria Branch, Centers for Diseases Control and Prevention, Atlanta, USA
| | - J F Lemoine
- Programme National de Contrôle du Paludisme, Port-au-Prince, Haiti
| | - C Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - T P Eisele
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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25
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Rogier E, Nace D, Dimbu PR, Wakeman B, Beeson JG, Drakeley C, Tetteh K, Plucinski M. Antibody dynamics in children with first or repeat Plasmodium falciparum infections. Front Med (Lausanne) 2022; 9:869028. [PMID: 35928289 PMCID: PMC9343764 DOI: 10.3389/fmed.2022.869028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Immunoglobulin (Ig) production during and after infection with Plasmodium parasites is one of the greatest adaptive immune defenses the human host has against this parasite. Infection with P. falciparum has been shown to induce different B cell maturation responses dependent upon the age of the patient, number of previous exposures, and severity of the disease. Described here are dynamics of Ig responses to a panel of 32 P. falciparum antigens by patients followed for 42 days and classified individuals as showing characteristics of an apparent first P. falciparum infection (naïve) or a repeat exposure (non-naïve). Six parameters were modeled to characterize the dynamics of IgM, IgG1, IgG3, and IgA for these two exposure groups with differences assessed among Ig isotypes/subclasses and unique antigens. Naïve patients had significantly longer periods of time to reach peak Ig titer (range 4–7 days longer) and lower maximum Ig titers when compared with non-naïve patients. Modeled time to seronegativity was significantly higher in non-naïve patients for IgM and IgA, but not for the two IgG subclasses. IgG1 responses to Rh2030, HSP40, and PfAMA1 were at the highest levels for non-naïve participants and may be used to predict previous or nascent exposure by themselves. The analyses presented here demonstrate the differences in the development of the Ig response to P. falciparum if the infection represents a boosting response or a primary exposure. Consistency in Ig isotype/subclasses estimates and specific data for P. falciparum antigens can better guide interpretation of seroepidemiological data among symptomatic persons.
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Affiliation(s)
- Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
- *Correspondence: Eric Rogier,
| | - Doug Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Brian Wakeman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James G. Beeson
- Burnet Institute, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Chris Drakeley
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kevin Tetteh
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mateusz Plucinski
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
- U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, United States
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26
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Mitchell KF, Carlson CM, Nace D, Wakeman BS, Drobeniuc J, Niemeyer GP, Werner B, Hoffmaster AR, Satheshkumar PS, Schuh AJ, Udhayakumar V, Rogier E. Evaluation of a Multiplex Bead Assay against Single-Target Assays for Detection of IgG Antibodies to SARS-CoV-2. Microbiol Spectr 2022; 10:e0105422. [PMID: 35647696 PMCID: PMC9241621 DOI: 10.1128/spectrum.01054-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/10/2022] [Indexed: 11/20/2022] Open
Abstract
Serological assays for SARS-CoV-2 antibodies must be validated for performance with a large panel of clinical specimens. Most existing assays utilize a single antigen target and may be subject to reduced diagnostic specificity. This study evaluated a multiplex assay that detects antibodies to three SARS-CoV-2 targets. Human serum specimens (n = 323) with known previous SARS-CoV-2 exposure status were tested on a commercially available multiplex bead assay (MBA) measuring IgG to SARS-CoV-2 spike protein receptor-binding domain (RBD), nucleocapsid protein (NP), and RBD/NP fusion antigens. Assay performance was evaluated against reverse transcriptase PCR (RT-PCR) results and also compared with test results for two single-target commercial assays. The MBA had a diagnostic sensitivity of 89.8% and a specificity of 100%, with serum collection at >28 days following COVID-19 symptom onset showing the highest seropositivity rates (sensitivity: 94.7%). The MBA performed comparably to single-target assays with the ability to detect IgG against specific antigen targets, with 19 (5.9%) discrepant specimens compared to the NP IgG assay and 12 (3.7%) compared to the S1 RBD IgG assay (kappa coefficients 0.92 and 0.88 compared to NP IgG and S1 RBD IgG assays, respectively. These findings highlight inherent advantages of using a SARS-CoV-2 serological test with multiple antigen targets; specifically, the ability to detect IgG against RBD and NP antigens simultaneously. In particular, the 100.0% diagnostic specificity exhibited by the MBA in this study is important for its implementation in populations with low SARS-CoV-2 seroprevalence or where background antibody reactivity to SARS-CoV-2 antigens has been detected. IMPORTANCE Reporting of SARS-CoV-2 infections through nucleic acid or antigen based diagnostic tests severely underestimates the true burden of exposure in a population. Serological data assaying for antibodies against SARS-CoV-2 antigens offers an alternative source of data to estimate population exposure, but most current immunoassays only include a single target for antibody detection. This report outlines a direct comparison of a multiplex bead assay to two other commercial single-target assays in their ability to detect IgG against SARS-CoV-2 antigens. Against a well-defined panel of 323 serum specimens, diagnostic sensitivity and specificity were very high for the multiplex assay, with strong agreement in IgG detection for single targets compared to the single-target assays. Collection of more data for individual- and population-level seroprofiles allows further investigation into more accurate exposure estimates and research into the determinants of infection and convalescent responses.
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Affiliation(s)
- Kaitlin F. Mitchell
- Laboratory Leadership Service assigned to Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christina M. Carlson
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Douglas Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brian S. Wakeman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Williams Consulting, LLC, Baltimore, Maryland, USA
| | - Jan Drobeniuc
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Glenn P. Niemeyer
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bonnie Werner
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alex R. Hoffmaster
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Amy J. Schuh
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Venkatachalam Udhayakumar
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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27
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Beshir KB, Parr JB, Cunningham J, Cheng Q, Rogier E. Screening strategies and laboratory assays to support Plasmodium falciparum histidine-rich protein deletion surveillance: where we are and what is needed. Malar J 2022; 21:201. [PMID: 35751070 PMCID: PMC9233320 DOI: 10.1186/s12936-022-04226-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
Rapid diagnostic tests (RDTs) detecting Plasmodium falciparum histidine-rich protein 2 (HRP2) have been an important tool for malaria diagnosis, especially in resource-limited settings lacking quality microscopy. Plasmodium falciparum parasites with deletion of the pfhrp2 gene encoding this antigen have now been identified in dozens of countries across Asia, Africa, and South America, with new reports revealing a high prevalence of deletions in some selected regions. To determine whether HRP2-based RDTs are appropriate for continued use in a locality, focused surveys and/or surveillance activities of the endemic P. falciparum population are needed. Various survey and laboratory methods have been used to determine parasite HRP2 phenotype and pfhrp2 genotype, and the data collected by these different methods need to be interpreted in the appropriate context of survey and assay utilized. Expression of the HRP2 antigen can be evaluated using point-of-care RDTs or laboratory-based immunoassays, but confirmation of a deletion (or mutation) of pfhrp2 requires more intensive laboratory molecular assays, and new tools and strategies for rigorous but practical data collection are particularly needed for large surveys. Because malaria diagnostic strategies are typically developed at the national level, nationally representative surveys and/or surveillance that encompass broad geographical areas and large populations may be required. Here is discussed contemporary assays for the phenotypic and genotypic evaluation of P. falciparum HRP2 status, consider their strengths and weaknesses, and highlight key concepts relevant to timely and resource-conscious workflows required for efficient diagnostic policy decision making.
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Affiliation(s)
- Khalid B Beshir
- Faculty of Infectious Diseases, London School of Hygiene and Tropical Diseases, Keppel Street, London, WC1E 7HT, UK
| | - Jonathan B Parr
- Division of Infectious Diseases and Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Jane Cunningham
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Qin Cheng
- Drug Resistance and Diagnostics, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.
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28
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McCaffery JN, Huber CS, Samai HM, Rogier E. Low Prevalence of Deletions of the pfhrp2 and pfhrp3 Genes in Plasmodium falciparum Parasites in Freetown, Sierra Leone in 2015. Am J Trop Med Hyg 2022; 106:1667-1669. [DOI: 10.4269/ajtmh.22-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/06/2022] [Indexed: 11/07/2022] Open
Abstract
ABSTRACT.
Sierra Leone relies heavily on histidine-rich protein 2–based diagnostics for malaria because of the high transmission of Plasmodium falciparum. During the 2015 recombinant vesicular stomatitis virus (VSV)−Zaire Ebola virus envelope glycoprotein (GP) vaccine trial, 77 participants with asymptomatic Plasmodium infection were enrolled, with all but four having P. falciparum malaria. Of the 73 participants with P. falciparum malaria, one infection (1 of 73, 1.4%; 95% CI, 0.03–7.4) showed P. falciparum with a pfhrp3 single deletion, and two P. falciparum infections (2 of 73, 2.7%; 95% CI, 0.03–9.6) showed pfhrp2/pfhrp3 dual deletions. This study shows evidence of pfhrp2- and pfhrp3-deleted parasites in Freetown, Sierra Leone. Additional studies for more precise estimates of prevalence are warranted.
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Affiliation(s)
- Jessica N. McCaffery
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
- Oak Ridge Associated Universities, Oak Ridge, Tennessee
| | - Curtis S. Huber
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hindolo M. Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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Leonard CM, Hwang J, Assefa A, Zulliger R, Candrinho B, Dimbu PR, Saifodine A, Plucinski M, Rogier E. Missed Plasmodium ovale infections among symptomatic persons in Angola, Mozambique, and Ethiopia. Open Forum Infect Dis 2022; 9:ofac261. [DOI: 10.1093/ofid/ofac261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
The majority of symptomatic malaria in sub-Saharan Africa are caused by Plasmodium falciparum. Infection with Plasmodium ovale is often not recorded and not considered clinically relevant. Here, we describe eight cases of P. ovale infection from three African countries – all of which were misdiagnosed at the presenting health facility.
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Affiliation(s)
- Colleen M. Leonard
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jimee Hwang
- U.S. President’s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Institute for Global Health and Infectious Disease, University of North Carolina at Chapel Hill, USA
| | - Rose Zulliger
- U.S. President's Malaria Initiative, United States Agency for International Development, Maputo, Mozambique
| | - Baltazar Candrinho
- National Malaria Control Program, Ministry of Health, Maputo, Mozambique
| | | | - Abuchahama Saifodine
- U.S. President's Malaria Initiative, United States Agency for International Development, Maputo, Mozambique
| | - Mateusz Plucinski
- U.S. President’s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Leonard CM, Assefa A, McCaffery JN, Herman C, Plucinski M, Sime H, Mohammed H, Kebede A, Solomon H, Haile M, Murphy M, Hwang J, Rogier E. Investigation of Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions and performance of a rapid diagnostic test for identifying asymptomatic malaria infection in northern Ethiopia, 2015. Malar J 2022; 21:70. [PMID: 35246151 PMCID: PMC8895513 DOI: 10.1186/s12936-022-04097-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis of both symptomatic and asymptomatic infections. Although RDTs are a reliable and practical diagnostic tool, the sensitivity of histidine-rich protein 2 (HRP2)-based RDTs can be reduced if pfhrp2 or pfhrp3 (pfhrp2/3) gene deletions exist in the Plasmodium falciparum parasite population. This study evaluated dried blood spot (DBS) samples collected from a national household survey to investigate the presence of pfhrp2/3 deletions and the performance of the RDT used in the cross-sectional survey in a low transmission setting. METHODS The 2015 Ethiopia Malaria Indicator Survey tested household members by RDT and collected DBS samples. DBS (n = 2648) from three regions in northern Ethiopia were tested by multiplex bead-based antigen detection assay after completion of the survey. The multiplex assay detected pan-Plasmodium lactate dehydrogenase (LDH), pAldolase, and HRP2 antigens in samples. Samples suspected for pfhrp2/3 gene deletions (pLDH and/or pAldolase positive but low or absent HRP2) were further investigated by molecular assays for gene deletions. Antigen results were also compared to each individual's RDT results. Dose-response logistic regression models were fit to estimate RDT level of detection (LOD) antigen concentrations at which 50, 75, 90, and 95% of the RDTs returned a positive result during this survey. RESULTS Out of 2,648 samples assayed, 29 were positive for pLDH or pAldolase antigens but low or absent for HRP2 signal, and 15 of these samples (51.7%) were successfully genotyped for pfhrp2/3. Of these 15 P. falciparum infections, eight showed single deletions in pfhrp3, one showed a single pfhrp2 deletion, and six were pfhrp2/3 double-deletions. Six pfhrp2 deletions were observed in Tigray and one in Amhara. Twenty-five were positive for HRP2 by the survey RDT while the more sensitive bead assay detected 30 HRP2-positive samples. A lower concentration of HRP2 antigen generated a positive test result by RDT compared to pLDH (95% LOD: 16.9 ng/mL vs. 319.2 ng/mL, respectively). CONCLUSIONS There is evidence of dual pfhrp2/3 gene deletions in the Tigray and Amhara regions of Ethiopia in 2015. As the prevalence of malaria was very low (< 2%), it is difficult to make strong conclusions on RDT performance, but these results challenge the utility of biomarkers in household surveys in very low transmission settings.
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Affiliation(s)
- Colleen M Leonard
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Oak Ridge Institute for Science and Education, US. Department of Energy, Oak Ridge, TN, 37831, USA
| | - Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.,Infectious Disease Ecology and Epidemiology Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jessica N McCaffery
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Oak Ridge Institute for Science and Education, US. Department of Energy, Oak Ridge, TN, 37831, USA
| | - Camelia Herman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Mateusz Plucinski
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Amha Kebede
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Hiwot Solomon
- Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Matt Murphy
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jimee Hwang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
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McCaffery JN, Munyaneza T, Uwimana A, Nace D, Lucchi N, Halsey ES, Rogier E. Symptomatic Plasmodium vivax Infection in Rwanda. Open Forum Infect Dis 2022; 9:ofac025. [PMID: 35187194 PMCID: PMC8849279 DOI: 10.1093/ofid/ofac025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/14/2022] [Indexed: 04/15/2024] Open
Abstract
We report a Plasmodium vivax infection in a Rwandan child misdiagnosed with Plasmodium falciparum and administered artemether-lumefantrine. Antigen detection revealed an absence of P falciparum histidine-rich protein 2 (HRP2) and presence of Plasmodium vivax lactate dehydrogenase. Nested and real-time polymerase chain reactions verified that the sample only contained P vivax deoxyribonucleic acid.
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Affiliation(s)
- Jessica N McCaffery
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA
| | | | - Aline Uwimana
- Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda
| | - Doug Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Naomi Lucchi
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. President’s Malaria Initiative, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda
| | - Eric S Halsey
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Rogier E, McCaffery JN, Nace D, Svigel SS, Assefa A, Hwang J, Kariuki S, Samuels AM, Westercamp N, Ratsimbasoa A, Randrianarivelojosia M, Uwimana A, Udhayakumar V, Halsey ES. Plasmodium falciparum pfhrp2 and pfhrp3 Gene Deletions from Persons with Symptomatic Malaria Infection in Ethiopia, Kenya, Madagascar, and Rwanda. Emerg Infect Dis 2022; 28:608-616. [PMID: 35201739 PMCID: PMC8888236 DOI: 10.3201/eid2803.211499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Histidine-rich protein 2 (HRP2)–based rapid diagnostic tests detect Plasmodium falciparum malaria and are used throughout sub-Saharan Africa. However, deletions in the pfhrp2 and related pfhrp3 (pfhrp2/3) genes threaten use of these tests. Therapeutic efficacy studies (TESs) enroll persons with symptomatic P. falciparum infection. We screened TES samples collected during 2016–2018 in Ethiopia, Kenya, Rwanda, and Madagascar for HRP2/3, pan-Plasmodium lactate dehydrogenase, and pan-Plasmodium aldolase antigen levels and selected samples with low levels of HRP2/3 for pfhrp2/3 genotyping. We observed deletion of pfhrp3 in samples from all countries except Kenya. Single-gene deletions in pfhrp2 were observed in 1.4% (95% CI 0.2%–4.8%) of Ethiopia samples and in 0.6% (95% CI 0.2%–1.6%) of Madagascar samples, and dual pfhrp2/3 deletions were noted in 2.0% (95% CI 0.4%–5.9%) of Ethiopia samples. Although this study was not powered for precise prevalence estimates, evaluating TES samples revealed a low prevalence of pfhrp2/3 deletions in most sites.
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Agbana HB, Rogier E, Lo A, Abukari Z, Jones S, Gyan B, Aidoo M, Amoah LE. Detecting asymptomatic carriage of Plasmodium falciparum in southern Ghana: utility of molecular and serological diagnostic tools. Malar J 2022; 21:57. [PMID: 35183178 PMCID: PMC8858553 DOI: 10.1186/s12936-022-04078-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/06/2022] [Indexed: 12/04/2022] Open
Abstract
Background Asymptomatic malaria infections can serve as potential reservoirs for malaria transmission. The density of parasites contained in these infections range from microscopic to submicroscopic densities, making the accurate detection of asymptomatic parasite carriage highly dependent on the sensitivity of the tools used for the diagnosis. This study sought to evaluate the sensitivities of a variety of molecular and serological diagnostic tools at determining the prevalence of asymptomatic Plasmodium falciparum parasite infections in two communities with varying malaria parasite prevalence. Methods Whole blood was collected from 194 afebrile participants aged between 6 and 70 years old living in a high (Obom) and a low (Asutsuare) malaria transmission setting of Ghana. Thick and thin blood smears, HRP2 based malaria rapid diagnostic test (RDT) and filter paper dried blood spots (DBS) were prepared from each blood sample. Genomic DNA was extracted from the remaining blood and used in Plasmodium specific photo-induced electron transfer polymerase chain reaction (PET-PCR) and Nested PCR, whilst the HRP2 antigen content of the DBS was estimated using a bead immunoassay. A comparison of malaria parasite prevalence as determined by each method was performed. Results Parasite prevalence in the high transmission site of Obom was estimated at 71.4%, 61.9%, 60%, 37.8% and 19.1% by Nested PCR, the HRP2 bead assay, PET-PCR, HRP2-RDT and microscopy respectively. Parasite prevalence in the low transmission site of Asutsuare was estimated at 50.1%, 11.2%, 5.6%, 0% and 2.2% by Nested PCR, the HRP2 bead assay, PET-PCR, RDT and microscopy, respectively. The diagnostic performance of Nested PCR, PET-PCR and the HRP2 bead assay was similar in Obom but in Asutsuare, Nested PCR had a significantly higher sensitivity than PET-PCR and the HRP2 bead assay, which had similar sensitivity. Conclusions Nested PCR exhibited the highest sensitivity by identifying the highest prevalence of asymptomatic P. falciparum in both the high and low parasite prevalence settings. However, parasite prevalence estimated by the HRP2 bead assay and PET-PCR had the highest level of inter-rater agreement relative to all the other tools tested and have the advantage of requiring fewer processing steps relative to Nested PCR and producing quantitative results. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04078-w.
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Louha S, Herman C, Gupta M, Patel D, Kelley J, OH JHM, Guru J, Lemoine JF, Chang MA, Venkatachalam U, Rogier E, Talundzic E. Evaluation of a parasite-density based pooled targeted amplicon deep sequencing (TADS) method for molecular surveillance of Plasmodium falciparum drug resistance genes in Haiti. PLoS One 2022; 17:e0262616. [PMID: 35030215 PMCID: PMC8759662 DOI: 10.1371/journal.pone.0262616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/30/2021] [Indexed: 12/04/2022] Open
Abstract
Sequencing large numbers of individual samples is often needed for countrywide antimalarial drug resistance surveillance. Pooling DNA from several individual samples is an alternative cost and time saving approach for providing allele frequency (AF) estimates at a population level. Using 100 individual patient DNA samples of dried blood spots from a 2017 nationwide drug resistance surveillance study in Haiti, we compared codon coverage of drug resistance-conferring mutations in four Plasmodium falciparum genes (crt, dhps, dhfr, and mdr1), for the same deep sequenced samples run individually and pooled. Samples with similar real-time PCR cycle threshold (Ct) values (+/- 1.0 Ct value) were combined with ten samples per pool. The sequencing success for samples in pools were higher at a lower parasite density than the individual samples sequence method. The median codon coverage for drug resistance-associated mutations in all four genes were greater than 3-fold higher in the pooled samples than in individual samples. The overall codon coverage distribution for pooled samples was wider than the individual samples. The sample pools with < 40 parasites/μL blood showed more discordance in AF calls for dhfr and mdr1 between the individual and pooled samples. This discordance in AF estimation may be due to low amounts of parasite DNA, which could lead to variable PCR amplification efficiencies. Grouping samples with an estimated ≥ 40 parasites/μL blood prior to pooling and deep sequencing yielded the expected population level AF. Pooling DNA samples based on estimates of > 40 parasites/μL prior to deep sequencing can be used for rapid genotyping of a large number of samples for these four genes and possibly other drug resistant markers in population-based studies. As Haiti is a low malaria transmission country with very few mixed infections and continued chloroquine sensitivity, the pooled sequencing approach can be used for routine national molecular surveillance of resistant parasites.
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Affiliation(s)
- Swarnali Louha
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States of America
- * E-mail:
| | - Camelia Herman
- Centers for Disease Control and Prevention Foundation, Atlanta, GA, United States America
| | - Mansi Gupta
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States of America
| | - Dhruviben Patel
- Williams Consulting LLC, Atlanta, GA, United States America
- Division of Parasitic Diseases and Malaria, Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States America
| | - Julia Kelley
- Centers for Disease Control and Prevention Foundation, Atlanta, GA, United States America
- Division of Parasitic Diseases and Malaria, Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States America
| | - Je-Hoon M. OH
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States of America
| | - Janani Guru
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States America
| | - Jean F. Lemoine
- Programme National de Contrôle de la Malaria, MSPP, Port-au-Prince, Haiti
| | - Michelle A. Chang
- Division of Parasitic Diseases and Malaria, Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States America
| | - Udhayakumar Venkatachalam
- Division of Parasitic Diseases and Malaria, Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States America
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States America
| | - Eldin Talundzic
- Division of Parasitic Diseases and Malaria, Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States America
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Mahon BE, Simon J, Widdowson MA, Samai M, Rogier E, Legardy-Williams J, Liu K, Schiffer J, Lange J, DeByle C, Pinner R, Schuchat A, Slutsker L, Goldstein S. Baseline Asymptomatic Malaria Infection and Immunogenicity of Recombinant Vesicular Stomatitis Virus-Zaire Ebola Virus Envelope Glycoprotein. J Infect Dis 2021; 224:1907-1915. [PMID: 34013349 PMCID: PMC8643414 DOI: 10.1093/infdis/jiab243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The effect of malaria infection on the immunogenicity of the recombinant vesicular stomatitis virus-Zaire Ebola virus envelope glycoprotein (GP) vaccine (rVSVΔG-ZEBOV-GP) (ERVEBO) is unknown. METHODS The Sierra Leone Trial to Introduce a Vaccine Against Ebola (STRIVE) vaccinated 7998 asymptomatic adults with rVSVΔG-ZEBOV-GP during the 2014-2016 Ebola epidemic. In STRIVE's immunogenicity substudy, participants provided blood samples at baseline and at 1, 6, and 9-12 months. Anti-GP binding and neutralizing antibodies were measured using validated assays. Baseline samples were tested for malaria parasites by polymerase chain reaction. RESULTS Overall, 506 participants enrolled in the immunogenicity substudy and had ≥1 postvaccination antibody titer. Of 499 participants with a result, baseline malaria parasitemia was detected in 73 (14.6%). All GP enzyme-linked immunosorbent assay (ELISA) and plaque reduction neutralization test (PRNT) geometric mean titers (GMTs) at 1, 6, and 9-12 months were above baseline, and 94.1% of participants showed seroresponse by GP-ELISA (≥2-fold rise and ≥200 ELISA units/mL), while 81.5% showed seroresponse by PRNT (≥4-fold rise) at ≥1 postvaccination assessment. In participants with baseline malaria parasitemia, the PRNT seroresponse proportion was lower, while PRNT GMTs and GP-ELISA seroresponse and GMTs showed a trend toward lower responses at 6 and 9-12 months. CONCLUSION Asymptomatic adults with or without malaria parasitemia had robust immune responses to rVSVΔG-ZEBOV-GP, persisting for 9-12 months. Responses in those with malaria parasitemia were somewhat lower.
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Affiliation(s)
- Barbara E Mahon
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jakub Simon
- Global Clinical Development–Vaccines, Merck & Co, Inc., Kenilworth, New Jersey, USA
| | | | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Kenneth Liu
- Biostatistics, Merck & Co, Inc., Kenilworth, New Jersey, USA
| | - Jarad Schiffer
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James Lange
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolynn DeByle
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert Pinner
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anne Schuchat
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Susan Goldstein
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Leonard CM, Mohammed H, Tadesse M, McCaffery JN, Nace D, Halsey ES, Girma S, Assefa A, Hwang J, Rogier E. Missed Plasmodium falciparum and Plasmodium vivax Mixed Infections in Ethiopia Threaten Malaria Elimination. Am J Trop Med Hyg 2021; 106:667-670. [PMID: 34847530 PMCID: PMC8832938 DOI: 10.4269/ajtmh.21-0796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/12/2021] [Indexed: 12/05/2022] Open
Abstract
Plasmodium falciparum and Plasmodium vivax are co-endemic in Ethiopia. This study investigated whether mixed infections were missed by microscopy from a 2017 therapeutic efficacy study at two health facilities in Ethiopia. All patients (N = 304) were initially classified as having single-species P. falciparum (n = 148 samples) or P. vivax infections (n = 156). Dried blood spots were tested for Plasmodium antigens by bead-based multiplex assay for pan-Plasmodium aldolase, pan-Plasmodium lactate dehydrogenase, P. vivax lactate dehydrogenase, and histidine-rich protein 2. Of 304 blood samples, 13 (4.3%) contained both P. falciparum and P. vivax antigens and were analyzed by polymerase chain reaction for species-specific DNA. Of these 13 samples, five were confirmed by polymerase chain reaction for P. falciparum/P. vivax co-infection. One sample, initially classified as P. vivax by microscopy, was found to only have Plasmodium ovale DNA. Plasmodium falciparum/P. vivax mixed infections can be missed by microscopy even in the context of a therapeutic efficacy study with multiple trained readers.
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Affiliation(s)
- Colleen M Leonard
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Jessica N McCaffery
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Doug Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric S Halsey
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.,U.S. President's Malaria Initiative, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Samuel Girma
- U.S. President's Malaria Initiative, USAID, Addis Ababa, Ethiopia
| | - Ashenafi Assefa
- Ethiopia Public Health Institute, Addis Ababa, Ethiopia.,Infectious Disease Ecology and Epidemiology Lab, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jimee Hwang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.,U.S. President's Malaria Initiative, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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Singh B, McCaffery JN, Kong A, Ah Y, Wilson S, Chatterjee S, Tomar D, Aidoo M, Udhayakumar V, Rogier E. Purification of native histidine-rich protein 2 (nHRP2) from Plasmodium falciparum culture supernatant, infected RBCs, and parasite lysate. Malar J 2021; 20:405. [PMID: 34657602 PMCID: PMC8522059 DOI: 10.1186/s12936-021-03946-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background Despite the widespread use of histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs), purified native HRP2 antigen is not standardly used in research applications or assessment of RDTs used in the field. Methods This report describes the purification of native HRP2 (nHRP2) from the HB3 Plasmodium falciparum culture strain. As this culture strain lacks pfhrp3 from its genome, it is an excellent source of HRP2 protein only and does not produce the closely-related HRP3. The nHRP2 protein was isolated from culture supernatant, infected red blood cells (iRBCs), and whole parasite lysate using nickel-metal chelate chromatography. Biochemical characterization of nHRP2 from HB3 culture was conducted by SDS-PAGE and western blotting, and nHRP2 was assayed by RDT, ELISA, and bead-based immunoassay. Results Purified nHRP2 was identified by SDS-PAGE and western blot as a − 60 kDa protein that bound anti-HRP-2 monoclonal antibodies. Mouse anti-HRP2 monoclonal antibody was found to produce high optical density readings between dilutions of 1:100 and 1:3,200 by ELISA with assay signal observed up to a 1:200,000 dilution. nHRP2 yield from HB3 culture by bead-based immunoassay revealed that both culture supernatant and iRBC lysate were practical sources of large quantities of this antigen, producing a total yield of 292.4 µg of nHRP2 from two pooled culture preparations. Assessment of nHRP2 recognition by RDTs revealed that Carestart Pf HRP2 and HRP2/pLDH RDTs detected purified nHRP2 when applied at concentrations between 20.6 and 2060 ng/mL, performing within a log-fold dilution of commercially-available recombinant HRP2. The band intensity observed for the nHRP2 dilutions was equivalent to that observed for P. falciparum culture strain dilutions of 3D7 and US06 F Nigeria XII between 12.5 and 1000 parasites/µL. Conclusions Purified nHRP2 could be a valuable reagent for laboratory applications as well as assessment of new and existing RDTs prior to their use in clinical settings. These results establish that it is possible to extract microgram quantities of the native HRP2 antigen from HB3 culture and that this purified protein is well recognized by existing monoclonal antibody lines and RDTs. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03946-1.
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Affiliation(s)
- Balwan Singh
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jessica N McCaffery
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Amy Kong
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Yong Ah
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Scott Wilson
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | | | - Deepak Tomar
- Department of Medicine, Division of Rheumatology, Emory University, Atlanta, GA, USA.,Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Michael Aidoo
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Venkatachalam Udhayakumar
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
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Leonard CM, Assefa A, Sime H, Mohammed H, Kebede A, Solomon H, Drakeley C, Murphy M, Hwang J, Rogier E. Spatial distribution of Plasmodium falciparum and P. vivax in northern Ethiopia by microscopy, rapid diagnostic test, laboratory antibody and antigen data. J Infect Dis 2021; 225:881-890. [PMID: 34628501 DOI: 10.1093/infdis/jiab489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Determining malaria transmission within regions of low, heterogenous prevalence is difficult. A variety of malaria tests exist and range from identification of diagnostic infection to testing for prior exposure. This study describes concordance of multiple malaria tests using data from a 2015 household survey conducted in Ethiopia. METHODS Blood samples (n= 2,279) from three regions in northern Ethiopia were assessed for Plasmodium falciparum and P. vivax by microscopy, rapid diagnostic test (RDT), multiplex antigen assay, and multiplex assay for IgG antibodies. Geospatial analysis was conducted with spatial scan statistics and kernel density estimation to identify hotspots of malaria by different test results. RESULTS Prevalence of malaria infection was low (1.4% by RDT, 1.0% by microscopy, and 1.8% by laboratory antigen assay). For P. falciparum, overlapping spatial clusters for all tests and an additional five unique IgG clusters were identified. For P. vivax, clusters identified for bead antigen assay, microscopy, and IgG with partial overlap. CONCLUSIONS Assessing the spatial distribution of malaria exposure using multiple metrics can improve the understanding of malaria transmission dynamics in a region. The relative abundance of antibody clusters indicates that in areas of low-transmission, IgG antibodies are a more useful marker to assess malaria exposure.
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Affiliation(s)
- Colleen M Leonard
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.,Infectious Disease ecology and epidemiology lab, University of North Carolina at Chapel Hill, USA
| | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Amha Kebede
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Hiwot Solomon
- Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Chris Drakeley
- Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matt Murphy
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.,U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jimee Hwang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.,U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
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39
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Sutcliffe AC, Irish SR, Rogier E, Finney M, Zohdy S, Dotson EM. Adaptation of ELISA detection of Plasmodium falciparum and Plasmodium vivax circumsporozoite proteins in mosquitoes to a multiplex bead-based immunoassay. Malar J 2021; 20:377. [PMID: 34556130 PMCID: PMC8461957 DOI: 10.1186/s12936-021-03910-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Plasmodium spp. sporozoite rates in mosquitoes are used to better understand malaria transmission intensity, the relative importance of vector species and the impact of interventions. These rates are typically estimated using an enzyme-linked immunosorbent assay (ELISA) utilizing antibodies against the circumsporozoite protein of Plasmodium falciparum, Plasmodium vivax VK210 (P. vivax210) or P. vivax VK247 (P. vivax247), employing assays that were developed over three decades ago. The ELISA method requires a separate assay plate for each analyte tested and can be time consuming as well as requiring sample volumes not always available. The bead-based multiplex platform allows simultaneous measurement of multiple analytes and may improve the lower limit of detection for sporozoites. METHODS Recombinant positive controls for P. falciparum, P. vivax210 and P. vivax247 and previously developed circumsporozoite (cs) ELISA antibodies were used to optimize conditions for the circumsporozoite multiplex bead assay (csMBA) and to determine the detection range of the csMBA. After optimizing assay conditions, known amounts of sporozoites were used to determine the lower limit of detection for the csELISA and csMBA and alternate cut-off measures were applied to demonstrate how cut-off criteria can impact lower limits of detection. Sporozoite rates from 1275 mosquitoes collected in Madagascar and 255 mosquitoes collected in Guinea were estimated and compared using the established csELISA and newly optimized csMBA. All mosquitoes were tested (initial test), and those that were positive were retested (retest). When sufficient sample volume remained, an aliquot of homogenate was boiled and retested (boiled retest), to denature any heat-unstable cross-reactive proteins. RESULTS Following optimization of the csMBA, the lower limit of detection was 25 sporozoites per mosquito equivalent for P. falciparum, P. vivax210 and P. vivax247 whereas the lower limits of detection for csELISA were found to be 1400 sporozoites for P. falciparum, 425 for P. vivax210 and 1650 for P. vivax247. Combined sporozoite rates after re-testing of samples that initially tested positive for Madagascar mosquitoes by csELISA and csMBA were 1.4 and 10.3%, respectively, and for Guinea mosquitoes 2% by both assays. Boiling of samples followed by csMBA resulted in a decrease in the Madagascar sporozoite rate to 2.8-4.4% while the Guinea csMBA sporozoite rate remained at 2.0%. Using an alternative csMBA cut-off value of median fluorescence intensity (MFI) of 100 yielded a sporozoite rate after confirmational testing of 3.7% for Madagascar samples and 2.0% for Guinea samples. Whether using csMBA or csELISA, the following steps may help minimize false positives: specimens are appropriately stored and bisected anterior to the thorax-abdomen junction, aliquots of homogenate are boiled and retested following initial testing, and an appropriate cut-off value is determined. CONCLUSIONS The csMBA is a cost-comparable and time saving alternative to the csELISA and may help eliminate false negatives due to a lower limit of detection, thus increasing sensitivity over the csELISA. The csMBA expands the potential analyses that can be done with a small volume of sample by allowing multiplex testing where analytes in addition to P. falciparum, P. vivax210 and P. vivax247 can be added following optimization.
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Affiliation(s)
- Alice C Sutcliffe
- The Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Entomology Branch, Atlanta, GA, USA.
| | - Seth R Irish
- The Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Entomology Branch, Atlanta, GA, USA
- President's Malaria Initiative, Atlanta, GA, USA
| | - Eric Rogier
- The Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Malaria Branch, Atlanta, GA, USA
| | - Micaela Finney
- College of Science and Mathematics, Auburn University, Auburn, AL, USA
- Entomology Department, College of Agriculture, Texas A&M University, College Station, TX, USA
| | - Sarah Zohdy
- The Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Malaria Branch, Atlanta, GA, USA
- School of Forestry and Wildlife Sciences, Auburn University, Auburn, AL, USA
- College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Ellen M Dotson
- The Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Entomology Branch, Atlanta, GA, USA
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40
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Rogier E, Herman C, Huber CS, Hamre KES, Pierre B, Mace KE, Présumé J, Mondélus G, Romilus I, Elismé T, Eisele TP, Druetz T, Existe A, Boncy J, Lemoine JF, Udhayakumar V, Chang MA. Nationwide Monitoring for Plasmodium falciparum Drug-Resistance Alleles to Chloroquine, Sulfadoxine, and Pyrimethamine, Haiti, 2016-2017. Emerg Infect Dis 2021; 26:902-909. [PMID: 32310062 PMCID: PMC7181918 DOI: 10.3201/eid2605.190556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Haiti is striving for zero local malaria transmission by the year 2025. Chloroquine remains the first-line treatment, and sulfadoxine/pyrimethamine (SP) has been used for mass drug-administration pilot programs. In March 2016, nationwide molecular surveillance was initiated to assess molecular resistance signatures for chloroquine and SP. For 778 samples collected through December 2017, we used Sanger sequencing to investigate putative resistance markers to chloroquine (Pfcrt codons 72, 74, 75, and 76), sulfadoxine (Pfdhps codons 436, 437, 540, 581, 613), and pyrimethamine (Pfdhfr codons 50, 51, 59, 108, 164). No parasites harbored Pfcrt point mutations. Prevalence of the Pfdhfr S108N single mutation was 47%, and we found the triple mutant Pfdhfr haplotype (108N, 51I, and 59R) in a single isolate. We observed no Pfdhps variants except in 1 isolate (A437G mutation). These data confirm the lack of highly resistant chloroquine and SP alleles in Haiti and support the continued use of chloroquine and SP.
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Cameron E, Young AJ, Twohig KA, Pothin E, Bhavnani D, Dismer A, Merilien JB, Hamre K, Meyer P, Le Menach A, Cohen JM, Marseille S, Lemoine JF, Telfort MA, Chang MA, Won K, Knipes A, Rogier E, Amratia P, Weiss DJ, Gething PW, Battle KE. Mapping the endemicity and seasonality of clinical malaria for intervention targeting in Haiti using routine case data. eLife 2021; 10:62122. [PMID: 34058123 PMCID: PMC8169118 DOI: 10.7554/elife.62122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 05/15/2021] [Indexed: 01/26/2023] Open
Abstract
Towards the goal of malaria elimination on Hispaniola, the National Malaria Control Program of Haiti and its international partner organisations are conducting a campaign of interventions targeted to high-risk communities prioritised through evidence-based planning. Here we present a key piece of this planning: an up-to-date, fine-scale endemicity map and seasonality profile for Haiti informed by monthly case counts from 771 health facilities reporting from across the country throughout the 6-year period from January 2014 to December 2019. To this end, a novel hierarchical Bayesian modelling framework was developed in which a latent, pixel-level incidence surface with spatio-temporal innovations is linked to the observed case data via a flexible catchment sub-model designed to account for the absence of data on case household locations. These maps have focussed the delivery of indoor residual spraying and focal mass drug administration in the Grand’Anse Department in South-Western Haiti.
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Affiliation(s)
- Ewan Cameron
- Curtin University, Perth, Australia.,Telethon Kids Institute, Perth Children's Hospital, Perth, Australia
| | - Alyssa J Young
- Clinton Health Access Initiative, Boston, United States.,Tulane University School of Public Health and Tropical Medicine, New Orleans, United States
| | - Katherine A Twohig
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Emilie Pothin
- Clinton Health Access Initiative, Boston, United States.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Amber Dismer
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, United States
| | | | - Karen Hamre
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, United States
| | - Phoebe Meyer
- Clinton Health Access Initiative, Boston, United States
| | | | | | - Samson Marseille
- Programme National de Contrôle de la Malaria/MSPP, Port-au-Prince, Haiti.,Direction d'Epidémiologie de Laboratoire et de la Recherche, Port-au-Prince, Haiti
| | | | | | - Michelle A Chang
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, United States
| | - Kimberly Won
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, United States
| | - Alaine Knipes
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, United States
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, United States
| | - Punam Amratia
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Daniel J Weiss
- Curtin University, Perth, Australia.,Telethon Kids Institute, Perth Children's Hospital, Perth, Australia
| | - Peter W Gething
- Curtin University, Perth, Australia.,Telethon Kids Institute, Perth Children's Hospital, Perth, Australia
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Druetz T, Stresman G, Ashton RA, Joseph V, van den Hoogen L, Worges M, Hamre KES, Fayette C, Monestime F, Impoinvil D, Rogier E, Chang MA, Lemoine JF, Drakeley C, Eisele TP. The Immediate Effects of a Combined Mass Drug Administration and Indoor Residual Spraying Campaign to Accelerate Progress towards Malaria Elimination in Grande-Anse, Haiti. J Infect Dis 2021; 225:1611-1620. [PMID: 33993294 PMCID: PMC9071345 DOI: 10.1093/infdis/jiab259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Haiti is planning targeted interventions to accelerate progress toward malaria elimination. In the most affected department (Grande-Anse), a combined mass drug administration (MDA) and indoor residual spraying (IRS) campaign was launched in October 2018. This study assessed the intervention’s effectiveness in reducing Plasmodium falciparum prevalence. Methods An ecological quasi-experimental study was designed, using a pretest and posttest with a nonrandomized control group. Surveys were conducted in November 2017 in a panel of easy access groups (25 schools and 16 clinics) and were repeated 2–6 weeks after the campaign, in November 2018. Single-dose sulfadoxine-pyrimethamine and primaquine was used for MDA, and pirimiphos-methyl as insecticide for IRS. Results A total of 10 006 participants were recruited. Fifty-two percent of the population in the intervention area reported having received MDA. Prevalence diminished between 2017 and 2018 in both areas, but the reduction was significantly larger in the intervention area (ratio of adjusted risk ratios, 0.32 [95% confidence interval, .104–.998]). Conclusions Despite a moderate coverage, the campaign was effective in reducing P. falciparum prevalence immediately after 1 round. Targeted MDA plus IRS is useful in preelimination settings to rapidly decrease the parasite reservoir, an encouraging step to accelerate progress toward malaria elimination.
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Affiliation(s)
- Thomas Druetz
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal QC, Canada.,Centre de Recherche en Santé Publique, Montreal QC, Canada
| | - Gillian Stresman
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth A Ashton
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Lotus van den Hoogen
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Matt Worges
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Karen E S Hamre
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA.,CDC Foundation, Atlanta GA, USA
| | | | | | - Daniel Impoinvil
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Michelle A Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population (MSPP), Port-au-Prince, Haiti
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas P Eisele
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
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Kong A, Wilson SA, Ah Y, Nace D, Rogier E, Aidoo M. HRP2 and HRP3 cross-reactivity and implications for HRP2-based RDT use in regions with Plasmodium falciparum hrp2 gene deletions. Malar J 2021; 20:207. [PMID: 33926477 PMCID: PMC8086288 DOI: 10.1186/s12936-021-03739-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/19/2021] [Indexed: 01/29/2023] Open
Abstract
Background The Plasmodium falciparum antigen histidine rich protein 2 (HRP2) is a preferred target for malaria rapid diagnostic tests (RDTs) because of its abundant production by the parasite and thermal stability. As a result, a majority of RDTs procured globally target this antigen. However, previous reports from South America and recent reports from sub-Saharan Africa and Asia indicate that certain P. falciparum parasites have deletions of the gene coding for HRP2. The HRP2 antigen is paralogous to another P. falciparum antigen HRP3 and some antibodies to HRP2 cross-react with HRP3. Multiple parasites have been described with deletions of one or both hrp2 and hrp3 genes. It is unclear how the various combinations of hrp2 and hrp3 deletion genotypes affect clinical sensitivity of HRP2-based RDTs. Methods Cross-reactivity between HRP2 and HRP3 was tested on malaria RDTs using culture-adapted P. falciparum parasites with both hrp2 and hrp3 intact or with one or both genes deleted. Ten-fold serial dilutions of four culture-adapted P. falciparum parasites [3D7 (hrp2+/hrp3+), Dd2 (hrp2−/hrp3+), HB3 (hrp2+/hrp3−) and 3BD5 (hrp2−/hrp3−)] ranging from 100,000 to 0.01 parasites/µL were prepared. HRP2, Plasmodium lactate dehydrogenase (pLDH) and aldolase concentrations were determined for the diluted samples using a multiplex bead assay. The samples were subsequently tested on three RDT products designed to detect P. falciparum by HRP2 alone or in combination with pLDH. Results At parasite densities of approximately 1000 parasites/µL, parasites that expressed either hrp2 or hrp3 were detected by all three RDTs. Multiplex based antigen measurement using HRP2- conjugated beads demonstrated higher antigen concentration when both hrp2 and hrp3 genes were intact (3D7 parasites, 47.9 ng/ml) compared to HB3 (3.02 ng/mL) and Dd2 (0.20 ng/mL) strains that had one gene deleted. 3D7 at 10 parasites/µL (0.45 ng/mL) was reactive on all three RDT products whereas none of the other parasites were reactive at that density. Conclusions Above a certain antigen threshold, HRP3 cross-reactivity on HRP2-based RDTs is sufficient to mask the effects of deletions of hrp2 only. Studies of hrp2 deletion and its effects on HRP2-based RDTs must be studied alongside hrp3 deletions and include clinical sample reactivity on HRP2-based tests.
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Affiliation(s)
- Amy Kong
- Malaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Scott A Wilson
- Malaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.,The CDC Foundation, 600 Peachtree Street NE, Suite 1000, Atlanta, GA, 30308, USA
| | - Yong Ah
- Malaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.,The CDC Foundation, 600 Peachtree Street NE, Suite 1000, Atlanta, GA, 30308, USA
| | - Douglas Nace
- Malaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Eric Rogier
- Malaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Michael Aidoo
- Malaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
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van den Hoogen LL, Herman C, Présumé J, Romilus I, Existe A, Boncy J, Joseph V, Stresman G, Tetteh KKA, Drakeley C, Chang MA, Lemoine JF, Eisele TP, Rogier E, Ashton RA. Rapid Screening for Non-falciparum Malaria in Elimination Settings Using Multiplex Antigen and Antibody Detection: Post Hoc Identification of Plasmodium malariae in an Infant in Haiti. Am J Trop Med Hyg 2021; 104:2139-2145. [PMID: 33819177 PMCID: PMC8176464 DOI: 10.4269/ajtmh.20-1450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/24/2020] [Indexed: 01/24/2023] Open
Abstract
Haiti is targeting malaria elimination by 2025. The Grand'Anse department in southwestern Haiti experiences one-third to half of all nationally reported Plasmodium falciparum cases. Although there are historical reports of Plasmodium vivax and Plasmodium malariae, today, non-falciparum infections would remain undetected because of extensive use of falciparum-specific histidine-rich protein 2 (HRP2) rapid diagnostic tests (RDT) at health facilities. A recent case-control study was conducted in Grand'Anse to identify risk factors for P. falciparum infection using HRP2-based RDTs (n = 1,107). Post hoc multiplex Plasmodium antigenemia and antibody (IgG) detection by multiplex bead assay revealed one blood sample positive for pan-Plasmodium aldolase, negative for P. falciparum HRP2, and positive for IgG antibodies to P. malariae. Based on this finding, we selected 52 samples with possible P. malariae infection using IgG and antigenemia data and confirmed infection status by species-specific PCR. We confirmed one P. malariae infection in a 6-month-old infant without travel history. Congenital P. malariae could not be excluded. However, our finding-in combination with historical reports of P. malariae-warrants further investigation into the presence and possible extent of non-falciparum malaria in Haiti. Furthermore, we showed the use of multiplex Plasmodium antigen and IgG detection in selecting samples of interest for subsequent PCR analysis, thereby reducing costs as opposed to testing all available samples by PCR. This is of specific use in low-transmission or eliminating settings where infections are rare.
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Affiliation(s)
- Lotus L. van den Hoogen
- Center for Applied Malaria Research and Evaluation, Tropical Medicine Department, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | | | | | | | | | - Jacques Boncy
- Laboratoire National de Santé Publique, Port-au-Prince, Haiti
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, Tropical Medicine Department, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Gillian Stresman
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kevin K. A. Tetteh
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chris Drakeley
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michelle A. Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jean F. Lemoine
- Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Thomas P. Eisele
- Center for Applied Malaria Research and Evaluation, Tropical Medicine Department, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ruth A. Ashton
- Center for Applied Malaria Research and Evaluation, Tropical Medicine Department, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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45
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Parr JB, Kieto E, Phanzu F, Mansiangi P, Mwandagalirwa K, Mvuama N, Landela A, Atibu J, Efundu SU, Olenga JW, Thwai KL, Morgan CE, Denton M, Poffley A, Juliano JJ, Mungala P, Likwela JL, Sompwe EM, Rogier E, Tshefu AK, N'Siala A, Kalonji A. Analysis of false-negative rapid diagnostic tests for symptomatic malaria in the Democratic Republic of the Congo. Sci Rep 2021; 11:6495. [PMID: 33753817 PMCID: PMC7985209 DOI: 10.1038/s41598-021-85913-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/08/2021] [Indexed: 11/29/2022] Open
Abstract
The majority of Plasmodium falciparum malaria diagnoses in Africa are made using rapid diagnostic tests (RDTs) that detect histidine-rich protein 2. Increasing reports of false-negative RDT results due to parasites with deletions of the pfhrp2 and/or pfhrp3 genes (pfhrp2/3) raise concern about existing malaria diagnostic strategies. We previously identified pfhrp2-negative parasites among asymptomatic children in the Democratic Republic of the Congo (DRC), but their impact on diagnosis of symptomatic malaria is unknown. We performed a cross-sectional study of false-negative RDTs in symptomatic subjects in 2017. Parasites were characterized by microscopy; RDT; pfhrp2/3 genotyping and species-specific PCR assays; a bead-based immunoassay for Plasmodium antigens; and/or whole-genome sequencing. Among 3627 symptomatic subjects, 427 (11.8%) had RDT-/microscopy + results. Parasites from eight (0.2%) samples were initially classified as putative pfhrp2/3 deletions by PCR, but antigen testing and whole-genome sequencing confirmed the presence of intact genes. 56.8% of subjects had PCR-confirmed malaria. Non-falciparum co-infection with P. falciparum was common (13.2%). Agreement between PCR and HRP2-based RDTs was satisfactory (Cohen's kappa = 0.66) and superior to microscopy (0.33). Symptomatic malaria due to pfhrp2/3-deleted P. falciparum was not observed. Ongoing HRP2-based RDT use is appropriate for the detection of falciparum malaria in the DRC.
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Affiliation(s)
- Jonathan B Parr
- Division of Infectious Diseases, Institute for Global Health and Infectious Diseases, University of North Carolina, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA.
| | - Eddy Kieto
- SANRU Asbl (Sante Rurale/Global Fund), Kinshasa, Democratic Republic of the Congo
| | - Fernandine Phanzu
- SANRU Asbl (Sante Rurale/Global Fund), Kinshasa, Democratic Republic of the Congo
| | - Paul Mansiangi
- University of Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | | | - Nono Mvuama
- University of Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Ange Landela
- Institut National Pour La Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Joseph Atibu
- University of Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | | | - Jean W Olenga
- SANRU Asbl (Sante Rurale/Global Fund), Kinshasa, Democratic Republic of the Congo
| | - Kyaw Lay Thwai
- Division of Infectious Diseases, Institute for Global Health and Infectious Diseases, University of North Carolina, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA
| | - Camille E Morgan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Madeline Denton
- Division of Infectious Diseases, Institute for Global Health and Infectious Diseases, University of North Carolina, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA
| | - Alison Poffley
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Jonathan J Juliano
- Division of Infectious Diseases, Institute for Global Health and Infectious Diseases, University of North Carolina, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Pomie Mungala
- SANRU Asbl (Sante Rurale/Global Fund), Kinshasa, Democratic Republic of the Congo
| | - Joris L Likwela
- SANRU Asbl (Sante Rurale/Global Fund), Kinshasa, Democratic Republic of the Congo
| | - Eric M Sompwe
- Programme National de La Lutte Contre Le Paludisme, Kinshasa, Democratic Republic of Congo
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30033, USA
| | - Antoinette K Tshefu
- University of Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Adrien N'Siala
- SANRU Asbl (Sante Rurale/Global Fund), Kinshasa, Democratic Republic of the Congo
| | - Albert Kalonji
- SANRU Asbl (Sante Rurale/Global Fund), Kinshasa, Democratic Republic of the Congo
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46
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Rogier E, Nace D, Dimbu PR, Wakeman B, Pohl J, Beeson JG, Drakeley C, Tetteh K, Plucinski M. Framework for Characterizing Longitudinal Antibody Response in Children After Plasmodium falciparum Infection. Front Immunol 2021; 12:617951. [PMID: 33737926 PMCID: PMC7960919 DOI: 10.3389/fimmu.2021.617951] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Human Plasmodium infection produces a robust adaptive immune response. Time courses for 104 children followed for 42 days after initiation of Plasmodium falciparum chemotherapy were assayed for antibody levels to the five isotypes of human immunoglobulins (Ig) and 4 subclasses of IgG for 32 P. falciparum antigens encompassing all 4 parasite stages of human infection. IgD and IgE against these antigens were undetectable at 1:100 serum concentration, but other Ig isotypes and IgG subclasses were consistently observed against all antigens. Five quantitative parameters were developed to directly compare Ig response among isotypes and antigens: Cmax, maximum antibody level; ΔC, difference between Cmax and the antibody level at Day 0; tmax, time in days to reach Cmax; t1/2, Ig signal half-life in days; tneg, estimated number of days until complete loss of Ig signal. Classical Ig patterns for a bloodborne pathogen were seen with IgM showing early tmax and IgG production highest among Ig isotypes. However, some unexpected trends were observed such as IgA showing a biphasic pattern for many antigens. Variability among these dynamics of Ig acquisition and loss was noted for different P. falciparum antigens and able to be compared both quantitatively and statistically. This parametrization methodology allows direct comparison of Ig isotypes produced against various Plasmodium antigens following malaria infection, and the same methodology could be applied to other longitudinal serologic studies from P. falciparum or different pathogens. Specifically for P. falciparum seroepidemiological studies, reliable and quantitative estimates regarding the IgG dynamics in human populations can better optimize modeling efforts for serological outputs.
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Affiliation(s)
- Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Doug Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Brian Wakeman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jan Pohl
- Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James G Beeson
- Burnet Institute, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kevin Tetteh
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mateusz Plucinski
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States.,U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, United States
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47
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McCaffery JN, Singh B, Nace D, Moreno A, Udhayakumar V, Rogier E. Natural infections with different Plasmodium species induce antibodies reactive to a chimeric Plasmodium vivax recombinant protein. Malar J 2021; 20:86. [PMID: 33579292 PMCID: PMC7880512 DOI: 10.1186/s12936-021-03626-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/04/2021] [Indexed: 12/18/2022] Open
Abstract
Background As malaria incidence and transmission in a region decreases, it becomes increasingly difficult to identify areas of active transmission. Improved methods for identifying and monitoring foci of active malaria transmission are needed in areas of low parasite prevalence in order to achieve malaria elimination. Serological assays can provide population-level infection history to inform elimination campaigns. Methods A bead-based multiplex antibody detection assay was used to evaluate a chimeric Plasmodium vivax MSP1 protein (PvRMC-MSP1), designed to be broadly immunogenic for use in vaccine studies, to act as a pan-malaria serological tool based on its ability to capture IgG in plasma samples obtained from naturally exposed individuals. Samples from 236 US travellers with PCR confirmed infection status from all four major Plasmodium species infecting humans, Plasmodium falciparum (n = 181), Plasmodium vivax (n = 38), Plasmodium malariae (n = 4), and Plasmodium ovale (n = 13) were tested for IgG capture using PvRMC-MSP1 as well as the four recombinant MSP1-19 kD isoforms representative of these Plasmodium species. Results Regardless of infecting Plasmodium species, a large proportion of plasma samples from infected US travellers provided a high assay signal to the PvRMC-MSP1 chimeric protein, with 115 high responders out of 236 samples assessed (48.7%). When grouped by active infection, 38.7% P. falciparum-, 92.1% of P. vivax-, 75.0% P. malariae-, and 53.4% of P. ovale-infected individuals displayed high assay signals in response to PvRMC-MSP1. It was also determined that plasma from P. vivax-infected individuals produced increased assay signals in response to the PvRMC-MSP1 chimera as compared to the recombinant PvMSP1 for 89.5% (34 out of 38) of individuals. PvRMC-MSP1 also showed improved ability to capture IgG antibodies from P. falciparum-infected individuals when compared to the capture by recombinant PvMSP1, with high assay signals observed for 38.7% of P. falciparum-infected travellers in response to PvRMC-MSP1 IgG capture compared to just 1.1% who were high responders to capture by the recombinant PvMSP1 protein. Conclusions These results support further study of designed antigens as an approach for increasing sensitivity or broadening binding capacity to improve existing serological tools for determining population-level exposure to Plasmodium species. Including both broad-reacting and Plasmodium species-specific antigen-coated beads in an assay panel could provide a nuanced view of population-level exposure histories, an extensive IgG profile, and detailed seroestimates. A more sensitive serological tool for detection of P. vivax exposure would aid malaria elimination campaigns in co-endemic areas and regions where P. vivax is the dominant parasite.
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Affiliation(s)
- Jessica N McCaffery
- Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, 954 Gatewood Road, Atlanta, GA, 30329, USA
| | - Balwan Singh
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Douglas Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Alberto Moreno
- Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, 954 Gatewood Road, Atlanta, GA, 30329, USA.,Division of Infectious Diseases, Department of Medicine, Emory University, 69 Jesse Hill, Jr. Drive, Atlanta, SEGA, 30303, USA
| | - Venkatachalam Udhayakumar
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
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48
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Rogier E, Hamre KES, Joseph V, Plucinski MM, Presume J, Romilus I, Mondelus G, Elisme T, van den Hoogen L, Lemoine JF, Drakeley C, Ashton RA, Chang MA, Existe A, Boncy J, Stresman G, Druetz T, Eisele TP. Conventional and High-Sensitivity Malaria Rapid Diagnostic Test Performance in 2 Transmission Settings: Haiti 2017. J Infect Dis 2020; 221:786-795. [PMID: 31630194 DOI: 10.1093/infdis/jiz525] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/16/2019] [Indexed: 01/24/2023] Open
Abstract
Accurate malaria diagnosis is foundational for control and elimination, and Haiti relies on histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs) identifying Plasmodium falciparum in clinical and community settings. In 2017, 1 household and 2 easy-access group surveys tested all participants (N = 32 506) by conventional and high-sensitivity RDTs. A subset of blood samples (n = 1154) was laboratory tested for HRP2 by bead-based immunoassay and for P. falciparum 18S rDNA by photo-induced electron transfer polymerase chain reaction. Both RDT types detected low concentrations of HRP2 with sensitivity estimates between 2.6 ng/mL and 14.6 ng/mL. Compared to the predicate HRP2 laboratory assay, RDT sensitivity ranged from 86.3% to 96.0% between tests and settings, and specificity from 90.0% to 99.6%. In the household survey, the high-sensitivity RDT provided a significantly higher number of positive tests, but this represented a very small proportion (<0.2%) of all participants. These data show that a high-sensitivity RDT may have limited utility in a malaria elimination setting like Haiti.
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Affiliation(s)
- Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Karen E S Hamre
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Mateusz M Plucinski
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jacquelin Presume
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Ithamare Romilus
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Gina Mondelus
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Tamara Elisme
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Lotus van den Hoogen
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Chris Drakeley
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ruth A Ashton
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Michelle A Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexandre Existe
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Jacques Boncy
- Laboratorie National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Gillian Stresman
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas Druetz
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.,Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, Quebec, Canada
| | - Thomas P Eisele
- Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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49
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Minta AA, Andre-Alboth J, Childs L, Nace D, Rey-Benito G, Boncy J, Adrien P, Francois J, Phaïmyr Jn Charles N, Blot V, Vanden Eng J, Priest JW, Rogier E, Tohme RA. Seroprevalence of Measles, Rubella, Tetanus, and Diphtheria Antibodies among Children in Haiti, 2017. Am J Trop Med Hyg 2020; 103:1717-1725. [PMID: 32618256 DOI: 10.4269/ajtmh.20-0112] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
In Haiti, measles, rubella, and maternal and neonatal tetanus have been eliminated, but a diphtheria outbreak is ongoing as of 2019. We conducted a nationally representative, household-based, two-stage cluster survey among children aged 5-7 years in 2017 to assess progress toward maintenance of control and elimination of selected vaccine-preventable diseases (VPDs). We stratified Haiti into West region (West department, including the capital city) and non-West region (all other departments). We obtained vaccination history and dried blood spots, and measured antibody concentrations to VPDs on a multiplex bead assay. Among 1,146 children, national seropositivity was 83% (95% CI: 80-86%) for tetanus, 83% (95% CI: 81-85%) for diphtheria, 87% (95% CI: 85-89%) for measles, and 84% (95% CI: 81-87%) for rubella. None of the children had long-term immunity to tetanus or diphtheria (IgG concentration ≥ 1 international unit/mL). Seropositivity in the West region was lower than that in the non-West region. Vaccination coverage was 68% (95% CI: 61-74%) for ≥ 3 doses of tetanus- and diphtheria-containing vaccine (DTP3), 84% (95% CI: 80-87%) for one dose of measles-rubella vaccine (MR1), and 20% (95% CI: 16-24%) for MR2. The seroprevalence of measles, rubella, and diphtheria antibodies is lower than population immunity levels needed to prevent disease transmission, particularly in the West region; reintroduction of these diseases could lead to an outbreak. To maintain VPD control and elimination, Haiti should achieve DTP3 and MR2 coverage ≥ 95%, and include tetanus and diphtheria booster doses in the routine immunization schedule.
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Affiliation(s)
- Anna A Minta
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jocelyne Andre-Alboth
- National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Lana Childs
- Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, Georgia.,Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Douglas Nace
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jacques Boncy
- National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Paul Adrien
- Directorate of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Jeannot Francois
- Expanded Program on Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | | | - Valery Blot
- Institut Haitien de l'Enfance, Pétion-Ville, Haiti
| | - Jodi Vanden Eng
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeffrey W Priest
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rania A Tohme
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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50
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Bakari C, Jones S, Subramaniam G, Mandara CI, Chiduo MG, Rumisha S, Chacky F, Molteni F, Mandike R, Mkude S, Njau R, Herman C, Nace DP, Mohamed A, Udhayakumar V, Kibet CK, Nyanjom SG, Rogier E, Ishengoma DS. Community-based surveys for Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions in selected regions of mainland Tanzania. Malar J 2020; 19:391. [PMID: 33148255 PMCID: PMC7640459 DOI: 10.1186/s12936-020-03459-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Histidine-rich protein 2 (HRP2)-based malaria rapid diagnostic tests (RDTs) are effective and widely used for the detection of wild-type Plasmodium falciparum infections. Although recent studies have reported false negative HRP2 RDT results due to pfhrp2 and pfhrp3 gene deletions in different countries, there is a paucity of data on the deletions of these genes in Tanzania. METHODS A community-based cross-sectional survey was conducted between July and November 2017 in four regions: Geita, Kigoma, Mtwara and Ruvuma. All participants had microscopy and RDT performed in the field and provided a blood sample for laboratory multiplex antigen detection (for Plasmodium lactate dehydrogenase, aldolase, and P. falciparum HRP2). Samples showing RDT false negativity or aberrant relationship of HRP2 to pan-Plasmodium antigens were genotyped to detect the presence/absence of pfhrp2/3 genes. RESULTS Of all samples screened by the multiplex antigen assay (n = 7543), 2417 (32.0%) were positive for any Plasmodium antigens while 5126 (68.0%) were negative for all antigens. The vast majority of the antigen positive samples contained HRP2 (2411, 99.8%), but 6 (0.2%) had only pLDH and/or aldolase without HRP2. Overall, 13 samples had an atypical relationship between a pan-Plasmodium antigen and HRP2, but were positive by PCR. An additional 16 samples with negative HRP2 RDT results but P. falciparum positive by microscopy were also chosen for pfhrp2/3 genotyping. The summation of false negative RDT results and laboratory antigen results provided 35 total samples with confirmed P. falciparum DNA for pfhrp2/3 genotyping. Of the 35 samples, 4 (11.4%) failed to consistently amplify positive control genes; pfmsp1 and pfmsp2 and were excluded from the analysis. The pfhrp2 and pfhrp3 genes were successfully amplified in the remaining 31 (88.6%) samples, confirming an absence of deletions in these genes. CONCLUSIONS This study provides evidence that P. falciparum parasites in the study area have no deletions of both pfhrp2 and pfhrp3 genes. Although single gene deletions could have been missed by the multiplex antigen assay, the findings support the continued use of HRP2-based RDTs in Tanzania for routine malaria diagnosis. There is a need for the surveillance to monitor the status of pfhrp2 and/or pfhrp3 deletions in the future.
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Affiliation(s)
- Catherine Bakari
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Sophie Jones
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Williams Consulting, Baltimore, MD, USA
| | - Gireesh Subramaniam
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Atlanta, GA, USA
| | - Celine I Mandara
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Mercy G Chiduo
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Susan Rumisha
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Frank Chacky
- National Malaria Control Programme (NMCP), Dodoma, Tanzania
| | | | - Renata Mandike
- National Malaria Control Programme (NMCP), Dodoma, Tanzania
| | - Sigsbert Mkude
- National Malaria Control Programme (NMCP), Dodoma, Tanzania
| | - Ritha Njau
- World Health Organization (WHO) Country Office, Dar es Salaam, Tanzania
| | - Camelia Herman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation (CDCF), Atlanta, GA, USA
| | - Douglas P Nace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ally Mohamed
- National Malaria Control Programme (NMCP), Dodoma, Tanzania
| | - Venkatachalam Udhayakumar
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Caleb K Kibet
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Steven G Nyanjom
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deus S Ishengoma
- National Institute for Medical Research, Dar es Salaam, Tanzania.
- Faculty of Pharmaceutical Sciences, Monash University, Melbourne, Australia.
- Harvard T.H Chan School of Public Health, Boston, MA, USA.
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