Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
J Infect Dis. 2022 Mar 2;225(5):881-890. doi: 10.1093/infdis/jiab489.
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 the concordance of multiple malaria tests using data from a 2015 household survey conducted in Ethiopia.
Blood samples (n=2279) from 3 regions in northern Ethiopia were assessed for Plasmodium falciparum and Plasmodium vivax by means of microscopy, rapid diagnostic test, multiplex antigen assay, and multiplex assay for immunoglobulin G (IgG) antibodies. Geospatial analysis was conducted with spatial scan statistics and kernel density estimation to identify malaria hot spots by different test results.
The prevalence of malaria infection was low (1.4% by rapid diagnostic test, 1.0% by microscopy, and 1.8% by laboratory antigen assay). For P. falciparum, overlapping spatial clusters for all tests and an additional 5 unique IgG clusters were identified. For P. vivax, clusters identified with bead antigen assay, microscopy, and IgG partially overlapped.
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.
在低流行、异质流行地区确定疟疾传播情况具有一定难度。目前存在多种疟疾检测方法，从诊断感染的鉴定到先前暴露的检测均有涉及。本研究描述了使用 2015 年在埃塞俄比亚进行的家庭调查数据对多种疟疾检测方法的一致性。
对来自埃塞俄比亚北部 3 个地区的 2279 份血样，分别采用显微镜检查、快速诊断检测、多重抗原检测和 IgG 抗体多重检测来检测恶性疟原虫和间日疟原虫。采用空间扫描统计和核密度估计进行地理空间分析，根据不同的检测结果确定疟疾热点。
疟疾感染的流行率较低（快速诊断检测为 1.4%，显微镜检查为 1.0%，实验室抗原检测为 1.8%）。对于恶性疟原虫，所有检测方法和另外 5 个独特的 IgG 聚类均有重叠的空间聚类。对于间日疟原虫， bead 抗原检测、显微镜检查和 IgG 确定的聚类部分重叠。
使用多种指标评估疟疾暴露的空间分布，可以更好地了解一个地区的疟疾传播动态。抗体聚类的相对丰度表明，在低传播地区，IgG 抗体是评估疟疾暴露的更有用的标志物。
