Oral Presentation First Malaria World Congress 2018

A novel point-of-contact test for malaria serosurveillance (#203)

Adam Hilton 1 , Myrte Huyskes 1 , David Anderson 1 , Mary Garcia 1 , James Beeson 1 2 , Philippe Boeuf 1 2
  1. Burnet Institute, Melbourne, VIC, Australia
  2. Department of Medicine, Peter Doherty Institute, The University of Melbourne, Parkville, Victoria, Australia

As we move from malaria control to elimination, fewer individuals are infected and typically harbour low-density parasitaemia. These individuals contribute significantly to malaria transmission but are not identified by current malaria infection diagnostic tests. A shift in operational approach is needed to detect these remaining hot-spots/hot-pops of transmission. By identifying malaria-exposed individuals based on the presence of antimalarial antibodies in their blood, serosurveillance could serve an integral role in malaria elimination. It can facilitate identifying remaining hot-spots/hot-pops of transmission, monitor Plasmodium transmission levels to prevent reintroduction of malaria and assess vaccine response/coverage. A point-of-contact serosurveillance test allows serosurveillance of remote regions where lab-resources may not be available and where hot-spots/hot-pops of transmission likely persist.

We developed a highly specific and sensitive lateral flow point-of-care serosurveillance tool for exposure to Plasmodium falciparum malaria. When compared against a lab-based reference test for antimalarial antibody detection (ELISA), our point-of-care test was able to detect recent malaria infection with 94.3% sensitivity and 100% specificity (n=95). Samples from individuals with naturally-acquired antibodies from an endemic setting were used to establish the test capacity to identify recently-exposed individuals as well as to highlight the prospect of large-scale sero-epidemiological studies to monitor temporal and spatial changes in transmission levels and enhance the planning process of control and treatment activities. Malaria-exposed travellers were tested to ascertain the capacity of the test to carry out serosurveillance of mobile communities (e.g. migrant workers) to prevent reintroduction of malaria. A vaccine trial population was tested to establish the potential use of the test for monitoring of vaccine response/coverage.

This test is currently being expanded to other malaria parasite species, especially Plasmodium vivax. Future studies will move onto field validation, as this test holds great promises to be a powerful and useful weapon in the fight against malaria.