Monitoring trends in malaria transmission using serological markers of malaria exposure. (360G-Wellcome-078925_Z_05_Z)

Planning of malaria prevention and control programmes requires knowledge of the regional, national and community level distribution of the parasite; monitoring the effectiveness of these programmes requires information about the change in parasite distribution over time. Furthermore, prediction of future malaria epidemics would be enhanced by being able to identify areas that were previously endemic for malaria or where previous epidemics have occurred. Existing methods for estimating malaria transmission and, thus, for assessing the burden of disease and need for prevention, are based on detection of circulating parasites in humans or of sporozoites in mosquitoes; both approaches lack precision and data are expensive to collect. Thus, we propose to evaluate the utility of serological parameters as measures of current and past malaria transmission intensity. This will include identification of suitably immunogenic and non-polymorphic antigens for use worldwide at all levels of trans mission; testing of serum samples from Africa, Asia and S. America, comparison of serological data with conventional measures of malaria transmission and mathematical modelling of these data to estimate exposure history, force of infection and likely outcomes of malaria interventions. The long term aim is to produce an assay for routine use for monitoring malaria transmission world wide.