Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
District Health Office of Gua Musang, Gua Musang, Kelantan, Malaysia.
Front Cell Infect Microbiol. 2023 Apr 20;13:1165634. doi: 10.3389/fcimb.2023.1165634. eCollection 2023.
Malaria remains a public health problem in many parts of the world. In Malaysia, the significant progress towards the national elimination programme and effective disease notification on malaria has resulted in zero indigenous human malaria cases since 2018. However, the country still needs to determine the extent of malaria exposure and transmission patterns, particularly in high-risk populations. In this study, a serological method was used to measure transmission levels of and among indigenous Orang Asli communities in Kelantan, Peninsular Malaysia. A community-based cross-sectional survey was conducted in three Orang Asli communities (i.e., Pos Bihai, Pos Gob, and Pos Kuala Betis) in Kelantan from June to July 2019. Antibody responses to malaria were assessed by enzyme-linked immunosorbent assay (ELISA) using two (PfAMA-1 and PfMSP-1) and two (PvAMA-1 and PvMSP-1) antigens. Age-adjusted antibody responses were analysed using a reversible catalytic model to calculate seroconversion rates (SCRs). Multiple logistic regression was used to investigate factors associated with malaria exposure. The overall malaria seroprevalence was 38.8% for PfAMA-1, 36.4% for PfMSP-1, 2.2% for PvAMA-1, and 9.3% for PvMSP-1. Between study areas, the proportion of seropositivity for any and antigens was significantly highest in Pos Kuala Betis with 34.7% ( < 0.001) and 13.6% ( < 0.001), respectively. For all parasite antigens except for PvAMA-1, the proportion of seropositive individuals significantly increased with age (all < 0.001). Based on the SCR, there was a higher level of transmission than in the study area. Multivariate regression analyses showed that living in Pos Kuala Betis was associated with both (adjusted odds ratio [aOR] 5.6, < 0.001) and (aOR 2.1, < 0.001) seropositivities. Significant associations were also found between age and seropositivity to and antigens. Analysis of community-based serological data helps describe the level of transmission, heterogeneity, and factors associated with malaria exposure among indigenous communities in Peninsular Malaysia. This approach could be an important adjunct tool for malaria monitoring and surveillance in low malaria transmission settings in the country.
疟疾仍然是世界许多地区的公共卫生问题。在马来西亚，国家消除规划取得了重大进展，疟疾疾病报告也十分有效，自 2018 年以来已无本土疟疾病例。然而，该国仍需确定疟疾暴露程度和传播模式，特别是在高危人群中。在这项研究中，采用血清学方法来测量马来西亚半岛吉兰丹州原住民部落的 和 传播水平。2019 年 6 月至 7 月，在吉兰丹州的三个原住民部落（即 Pos Bihai、Pos Gob 和 Pos Kuala Betis）进行了一项基于社区的横断面调查。使用两种 （PfAMA-1 和 PfMSP-1）和两种 （PvAMA-1 和 PvMSP-1）抗原通过酶联免疫吸附试验（ELISA）评估对疟疾的抗体反应。使用可逆催化模型分析年龄调整后的抗体反应，以计算血清转化率（SCR）。多因素逻辑回归用于调查与疟疾暴露相关的因素。PfAMA-1 的总体疟疾血清阳性率为 38.8%，PfMSP-1 为 36.4%，PvAMA-1 为 2.2%，PvMSP-1 为 9.3%。在研究区域之间，Pos Kuala Betis 对任何 和 抗原的血清阳性率均最高，分别为 34.7%（<0.001）和 13.6%（<0.001）。除 PvAMA-1 外，所有寄生虫抗原的血清阳性个体比例均随年龄增长而显著增加（均<0.001）。根据 SCR，研究区域的 传播水平高于 。多因素回归分析表明，居住在 Pos Kuala Betis 与 （调整后的优势比[aOR]5.6，<0.001）和 （aOR 2.1，<0.001）血清阳性均相关。年龄与 和 抗原的血清阳性之间也存在显著关联。基于社区的血清学数据分析有助于描述马来西亚半岛原住民社区的传播水平、异质性和与疟疾暴露相关的因素。这种方法可能是该国低疟疾传播环境中疟疾监测和监测的重要辅助工具。
