A Longitudinal Cohort Study of Malaria Exposure and Changing Serostatus in a Malaria Endemic Area of Rural Tanzania
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<h4>Background</h4>Measurements of anti-malarial antibodies are increasingly used as a proxy of transmission intensity. Most serological surveys are based on the use of cross-sectional data that, when age-stratified, approximates historical patterns of transmission within a population. Comparatively few studies leverage longitudinal data to explicitly relate individual infection events with subsequent antibody responses.<h4>Methods</h4>The occurrence of seroconversion and seroreversion events for two Plasmodium falciparum asexual stage antigens (MSP-1 and AMA-1) was examined using three annual measurements of 691 individuals from a cohort of individuals in a malaria-endemic area of rural east-central Tanzania. Mixed-effect logistic regression models were employed to determine factors associated with changes in serostatus over time.<h4>Results</h4>While the expected population-level relationship between seroprevalence and disease incidence was observed, on an individual level the relationship between individual infections and the antibody response was complex. MSP-1 antibody responses were more dynamic in response to the occurrence and resolution of infection events than AMA-1, while the latter was more correlated with consecutive infections. The MSP-1 antibody response to an observed infection seemed to decay faster over time than the corresponding AMA-1 response. Surprisingly, there was no evidence of an age effect on the occurrence of a conversion or reversion event.<h4>Conclusions</h4>While the population-level results concur with previously published sero-epidemiological surveys, the individual-level results highlight the more complex relationship between detected infections and antibody dynamics than can be analysed using cross-sectional data. The longitudinal analysis of serological data may provide a powerful tool for teasing apart the complex relationship between infection events and the corresponding immune response, thereby improving the ability to rapidly assess the success or failure of malaria control programmes.
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Published Version (Please cite this version)10.1186/s12936-017-1945-2
Publication InfoSimmons, RA; Mboera, L; Stresman, A; Turner, E; Kramer, R; Drakeley, C; & O'Meara, WP (2017). A Longitudinal Cohort Study of Malaria Exposure and Changing Serostatus in a Malaria Endemic Area of Rural Tanzania. Malaria Journal, 16(309). pp. 309. 10.1186/s12936-017-1945-2. Retrieved from https://hdl.handle.net/10161/24522.
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Professor Emeritus of Environmental Economics
Before coming to Duke in 1988, he was on the faculty at Virginia Polytechnic Institute and State University. He has held visiting positions at IUCN--The World Conservation Union, the Economic Growth Center at Yale University, and the Indonesian Ministry of Forestry. He has served as a consultant to the World Bank, World Health Organization and other international organizations. He was named Duke University's Scholar Teacher of the Year in 2004. Kramer's research is focused on the econ
Wendy P O'Meara
Associate Professor of Medicine
Dr. Wendy O’Meara is an Associate Professor at Duke University School of Medicine in the Division of Infectious Diseases, visiting professor at Moi University, and the Associate Director for Research of the Duke Global Health Institute. She has been based full-time in Kenya since 2007. Dr. O’Meara’s team is interested in improving rational drug use for suspected malaria fevers through expanding the use of diagnostic tools in the community and in health facilities. As
Education: Masters Degree, Biostatistics. Duke University School of Medicine. 2015
Elizabeth Louise Turner
Associate Professor of Biostatistics & Bioinformatics
Dr. Turner is Associate Professor of Biostatistics and Global Health and serves as Director of the Research Design and Analysis Core of the Duke Global Health Institute. Her primary methodological focus is on the design and analysis of randomized controlled trials, particularly those that involve clustering such as cluster randomized trials (CRTs), stepped wedge CRTs and individually-randomized group treatment trials. She is expert in the implementation of trials in low resource settings, with a
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