A Longitudinal Cohort Study of Malaria Exposure and Changing Serostatus in a Malaria Endemic Area of Rural Tanzania

Simmons, RA; Mboera, L; Stresman, A; Turner, E; Kramer, R; Drakeley, C; O'Meara, WP

A Longitudinal Cohort Study of Malaria Exposure and Changing Serostatus in a Malaria Endemic Area of Rural Tanzania

dc.contributor.author	Simmons, RA
dc.contributor.author	Mboera, L
dc.contributor.author	Stresman, A
dc.contributor.author	Turner, E
dc.contributor.author	Kramer, R
dc.contributor.author	Drakeley, C
dc.contributor.author	O'Meara, WP
dc.date.accessioned	2022-03-04T17:00:15Z
dc.date.available	2022-03-04T17:00:15Z
dc.date.issued	2017-08-02
dc.date.updated	2022-03-04T17:00:14Z
dc.description.abstract	Background 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. Methods 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. Results 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. Conclusions 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.
dc.identifier	10.1186/s12936-017-1945-2
dc.identifier.issn	1475-2875
dc.identifier.issn	1475-2875
dc.identifier.uri	https://hdl.handle.net/10161/24522
dc.language	eng
dc.publisher	BioMed Central
dc.relation.ispartof	Malaria Journal
dc.relation.isversionof	10.1186/s12936-017-1945-2
dc.subject	Humans
dc.subject	Malaria, Falciparum
dc.subject	Membrane Proteins
dc.subject	Protozoan Proteins
dc.subject	Merozoite Surface Protein 1
dc.subject	Antigens, Protozoan
dc.subject	Prevalence
dc.subject	Longitudinal Studies
dc.subject	Cross-Sectional Studies
dc.subject	Seroepidemiologic Studies
dc.subject	Age Factors
dc.subject	Adolescent
dc.subject	Adult
dc.subject	Middle Aged
dc.subject	Child
dc.subject	Child, Preschool
dc.subject	Infant
dc.subject	Infant, Newborn
dc.subject	Rural Population
dc.subject	Tanzania
dc.subject	Female
dc.subject	Male
dc.subject	Young Adult
dc.title	A Longitudinal Cohort Study of Malaria Exposure and Changing Serostatus in a Malaria Endemic Area of Rural Tanzania
dc.type	Journal article
duke.contributor.orcid	Turner, E\|0000-0002-7638-5942
duke.contributor.orcid	Kramer, R\|0000-0002-1325-7425
duke.contributor.orcid	O'Meara, WP\|0000-0001-9455-3965
pubs.begin-page	309
pubs.issue	309
pubs.organisational-group	Duke
pubs.organisational-group	Nicholas School of the Environment
pubs.organisational-group	School of Medicine
pubs.organisational-group	Trinity College of Arts & Sciences
pubs.organisational-group	Basic Science Departments
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Biostatistics & Bioinformatics
pubs.organisational-group	Medicine
pubs.organisational-group	Medicine, Infectious Diseases
pubs.organisational-group	Economics
pubs.organisational-group	Environmental Sciences and Policy
pubs.organisational-group	Institutes and Provost's Academic Units
pubs.organisational-group	University Institutes and Centers
pubs.organisational-group	Duke Global Health Institute
pubs.organisational-group	Initiatives
pubs.organisational-group	Duke Science & Society
pubs.organisational-group	Nicholas Institute-Energy Initiative
pubs.publication-status	Published
pubs.volume	16