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Open Access Research article

Marked variation in MSP-119 antibody responses to malaria in western Kenyan highlands

Kingsley Badu12*, Yaw Asare Afrane1, John Larbi2, Virginia Ann Stewart3, John Waitumbi3, Evelina Angov4, John M Ong'echa56, Douglas J Perkins56, Guofa Zhou7, Andrew Githeko1 and Guiyun Yan7

Author Affiliations

1 Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

2 Department of Theoretical and Applied Biology, College of Sciences, Kwame Nkrumah, University of Science & Technology, Kumasi, Ghana

3 Walter Reed Project, United States Army Medical Research Unit-Kisumu, Kisumu, Kenya

4 Division of Malaria Vaccine Development, United States Military Malaria Vaccine Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA

5 Center for Global Health, University of New Mexico, Albuquerque, NM, USA

6 Laboratory of Viral and Parasitic Diseases, University of New Mexico/KEMRI, Centre for Global Health Research, Kisumu, Kenya

7 Program in Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA 92697, USA

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BMC Infectious Diseases 2012, 12:50  doi:10.1186/1471-2334-12-50

Published: 1 March 2012

Abstract

Background

Assessment of malaria endemicity at different altitudes and transmission intensities, in the era of dwindling vector densities in the highlands, will provide valuable information for malaria control and surveillance. Measurement of serum anti-malarial antibodies is a useful marker of malaria exposure that indicates long-term transmission potential. We studied the serologic evidence of malaria endemicity at two highland sites along a transmission intensity cline. An improved understanding of the micro-geographic variation in malaria exposure in the highland ecosystems will be relevant in planning effective malaria control.

Methods

Total IgG levels to Plasmodium falciparum MSP-119 were measured in an age-stratified cohort (< 5, 5-14 and ≥ 15 years) in 795 participants from an uphill and valley bottom residents during low and high malaria transmission seasons. Antibody prevalence and level was compared between different localities. Regression analysis was performed to examine the association between antibody prevalence and parasite prevalence. Age-specific MSP-119 seroprevalence data was fitted to a simple reversible catalytic model to investigate the relationship between parasite exposure and age.

Results

Higher MSP-119 seroprevalence and density were observed in the valley residents than in the uphill dwellers. Adults (> 15 years) recorded high and stable immune response in spite of changing seasons. Lower responses were observed in children (≤ 15 years), which, fluctuated with changing seasons particularly in the valley residents. In the uphill population, annual seroconversion rate (SCR) was 8.3% and reversion rate was 3.0%, with seroprevalence reaching a plateau of 73.3% by age of 20. Contrary, in the valley bottom population, the annual SCR was 35.8% and the annual seroreversion rate was 3.5%, and seroprevalence in the population had reached 91.2% by age 10.

Conclusion

The study reveals the micro-geographic variation in malaria endemicity in the highland eco-system; this validates the usefulness of sero-epidemiological tools in assessing malaria endemicity in the era of decreasing sensitivity of conventional tools.