Elliott Salenna R, Fowkes Freya J I, Richards Jack S, Reiling Linda, Drew Damien R, Beeson James G
Burnet Institute 85 Commercial Road, Melbourne, Victoria 3004 Australia.
Burnet Institute 85 Commercial Road, Melbourne, Victoria 3004 Australia ; School of Epidemiology and Preventive Medicine, Monash University 99 Commercial Road, Victoria 3004 Australia ; School of Population Health and Department of Medicine (RMH), University of Melbourne Victoria 3010 Australia.
F1000Prime Rep. 2014 Nov 4;6:100. doi: 10.12703/P6-100. eCollection 2014.
Surveillance is a key component of control and elimination programs. Malaria surveillance has been typically reliant on case reporting by health services, entomological estimates and parasitemia (Plasmodium species) point prevalence. However, these techniques become less sensitive and relatively costly as transmission declines. There is great potential for the development and application of serological biomarkers of malaria exposure as sero-surveillance tools to strengthen malaria control and elimination. Antibodies to malaria antigens are sensitive biomarkers of population-level malaria exposure and can be used to identify hotspots of malaria transmission, estimate transmission levels, monitor changes over time or the impact of interventions on transmission, confirm malaria elimination, and monitor re-emergence of malaria. Sero-surveillance tools could be used in reference laboratories or developed as simple point-of-care tests for community-based surveillance, and different applications and target populations dictate the technical performance required from assays that are determined by properties of antigens and antibody responses. To advance the development of sero-surveillance tools for malaria elimination, major gaps in our knowledge need to be addressed through further research. These include greater knowledge of potential antigens, the sensitivity and specificity of antibody responses, and the longevity of these responses and defining antigens and antibodies that differentiate between exposure to Plasmodium falciparum and P. vivax. Additionally, a better understanding of the influence of host factors, such as age, genetics, and comorbidities on antibody responses in different populations is needed.
监测是控制和消除规划的关键组成部分。疟疾监测通常依赖于卫生服务机构的病例报告、昆虫学估计以及寄生虫血症（疟原虫种类）的点患病率。然而，随着传播率下降，这些技术的敏感性降低且成本相对较高。作为血清学监测工具，开发和应用疟疾暴露的血清生物标志物对于加强疟疾控制和消除具有巨大潜力。针对疟疾抗原的抗体是人群层面疟疾暴露的敏感生物标志物，可用于识别疟疾传播热点、估计传播水平、监测随时间的变化或干预措施对传播的影响、确认疟疾消除以及监测疟疾的再次出现。血清学监测工具可用于参考实验室，或开发为用于社区监测的简单即时检验，不同的应用和目标人群决定了由抗原和抗体反应特性所决定的检测所需的技术性能。为推动用于消除疟疾的血清学监测工具的开发，需要通过进一步研究来填补我们知识上的重大空白。这些空白包括对潜在抗原、抗体反应的敏感性和特异性以及这些反应的持久性有更深入的了解，确定区分感染恶性疟原虫和间日疟原虫的抗原和抗体。此外，还需要更好地了解宿主因素，如年龄、遗传学和合并症对不同人群抗体反应的影响。
