Malaria Elimination: The Role and Value of Sero-Surveillance

Abstract

As countries move from intense malaria transmission to low transmission there will be a demand for more sensitive tools and approaches in tracking malaria transmission dynamics. Surveillance tools that are sensitive in tracking real time infectious bites as well as infectious reservoir will be preferred to counting number of cases in the hospital or parasite prevalence. The acquisition and maintenance of anti-malarial antibodies is a direct function of parasite exposure, seroprevalence rates has been used as an efficient tool in assessing malaria endemicity and confirming malaria elimination. Plasmodium antibodies are explicit biomarkers that can be utilised to track parasite exposure over more extensive time spans than microscopy, rapid diagnostic testing or molecular testing and the conventional entomological inoculation rate. Seroprevalence studies can therefore help monitor the impact of malaria control interventions, especially when the parasite occurrence is low. As a result, antibody responses to Anopheles salivary proteins or Plasmodium species may potentially offer reliable information of recent or past exposure; recognise short-term or gradual changes in exposure to Plasmodium infection or to estimate individual-level exposure to infection. This book chapter will present about four studies we have conducted across eastern and western Africa on the efficiency of salivary gland proteins and antimalarial antibodies in tracking malaria transmission intensity. We hope that these could be used as surveillance tools in malaria elimination efforts.