Considerable success in reducing malaria incidence and mortality has been achieved in Brazil, leading to discussions over the possibility of moving towards elimination. However, more than reporting and counting clinical cases, elimination will require the use of efficient tools and strategies for measuring transmission dynamics and detecting the infectious reservoir as the primary indicators of interest for surveillance and evaluation. Because acquisition and maintenance of anti-malarial antibodies depend on parasite exposure, seroprevalence rates could be used as a reliable tool for assessing malaria endemicity and an adjunct measure for monitoring transmission in a rapid and cost-effective manner.
This systematic review synthesizes the existing literature on seroprevalence of malaria in the Brazilian Amazon Basin. Different study designs (cross-sectional surveys and longitudinal studies) with reported serological results in well-defined Brazilian populations were considered. Medline (via PubMed), EMBASE and LILACS databases were screened and the articles were included per established selection criteria. Data extraction was performed by two authors and a modified critical appraisal tool was applied to assess the quality and completeness of cross-sectional studies regarding defined variables of interest.
From 220 single records identified, 23 studies were included in this systematic review for the qualitative synthesis. Five studies reported serology results on Plasmodium falciparum, 14 papers assessed Plasmodium vivax and four articles reported results on both Plasmodium species. Considerable heterogeneity among the evaluated malarial antigens, including sporozoite and blood stage antigens, was observed. The majority of recent studies analysed IgG responses against P. vivax antigens reflecting the species distribution pattern in Brazil over the last decades. Most of the published papers were cross-sectional surveys (73.9%) and only six cohort studies were included in this review. Three studies pointed to an association between antibodies against circumsporozoite protein of both P. falciparum and P. vivax and malaria exposure. Furthermore, five out 13 cross-sectional studies evidenced a positive association between IgG antibodies to the conserved 19-kDa C-terminal region of the merozoite surface protein 1 of P. vivax (PvMSP119) and malaria exposure.
This systematic review identifies potential biomarkers of P. falciparum and P. vivax exposure in areas with variable and unstable malaria transmission in Brazil. However, this study highlights the need for standardization of further studies to provide an ideal monitoring tool to evaluate trends in malaria transmission and the effectiveness of malaria intervention programmes in Brazil. Moreover, the score-based weighted tool developed and used in this study still requires further validation.
WHO. World malaria report 2016. Geneva: World Health Organization; 2016.
Coura JR, Suarez-Mutis M, Ladeia-Andrade S. A new challenge for malaria control in Brazil: asymptomatic Plasmodium infection—a review. Mem Inst Oswaldo Cruz. 2006;101:229–37. PubMed
WHO. Roll back malaria partnership: disease surveillance for malaria control: an operational manual. Geneva: World Health Organization; 2012.
Oliveira-Ferreira J, Nakaie CR, Daniel-Ribeiro C. Low frequency of anti- Plasmodium falciparum circumsporozoite repeat antibodies and rate of high malaria transmission in endemic areas of Rondônia State in northwestern Brazil. Am J Trop Med Hyg. 1992;46:720–6. PubMed
Jeffery GM, McWilson W, Collins WE, Lobel H. Application of the indirect fluorescent antibody method in a study of malaria endemicity in Mato Grosso, Brazil. Am J Trop Med Hyg. 1975;24:402–11. PubMed
Loiola CCP, Silva CJM, Tauil PL. Controle da malária no Brasil: 1965 a 2001. Pan Am J Public Health. 2002;11:235–44. CrossRef
Ferraroni JJ, Lacaz Cda S. Prevalence of antibodies against agents causing hepatitis, malaria, syphilis and toxoplasmosis in 5 different human populations of the Brazilian Amazonia. Rev Inst Med Trop Sao Paulo. 1982;24:155–61. PubMed
Kremsner PG, Neifer S, Zotter GM, Bienzle U, Rocha RM, Maracic M, et al. Prevalence and level of antibodies to the circumsporozoite proteins of human malaria parasites, including a variant of Plasmodium vivax, in the population of two epidemiologically distinct areas in the state of Acre, Brazil. Trans R Soc Trop Med Hyg. 1992;86:23–7. CrossRefPubMed
Scopel KK, da Silva-Nunes M, Malafronte RS, Braga EM, Ferreira MU. Variant-specific antibodies to merozoite surface protein 2 and clinical expression of Plasmodium falciparum malaria in rural Amazonians. Am J Trop Med Hyg. 2007;76:1084–91. PubMed
Ladeia-Andrade S, Ferreira MU, Scopel KK, Braga EM, Bastos Mda S, Wunderlich G, et al. Naturally acquired antibodies to merozoite surface protein (MSP)-1(19) and cumulative exposure to Plasmodium falciparum and Plasmodium vivax in remote populations of the Amazon Basin of Brazil. Mem Inst Oswaldo Cruz. 2007;102:943–51. CrossRefPubMed
Sanchez-Arcila JC, de Franca MM, Pereira VA, Vasconcelos MP, Teva A, Perce-da-Silva Dde S, et al. The influence of intestinal parasites on Plasmodium vivax-specific antibody responses to MSP-119 and AMA-1 in rural populations of the Brazilian Amazon. Malar J. 2015;14:442. CrossRefPubMedCentralPubMed
Lima-Junior JC, Jiang J, Rodrigues-da-Silva RN, Banic DM, Tran TM, Ribeiro RY, et al. B cell epitope mapping and characterization of naturally acquired antibodies to the Plasmodium vivax merozoite surface protein-3 alpha (PvMSP-3alpha) in malaria exposed individuals from Brazilian Amazon. Vaccine. 2011;29:1801–11. CrossRefPubMedCentralPubMed
Lima-Junior JC, Rodrigues-da-Silva RN, Banic DM, Jiang J, Singh B, Fabricio-Silva GM, et al. Influence of HLA-DRB1 and HLA-DQB1 alleles on IgG antibody response to the P. vivax MSP-1, MSP-3alpha and MSP-9 in individuals from Brazilian endemic area. PLoS ONE. 2012;7:e36419. CrossRefPubMedCentralPubMed
Rodrigues-da-Silva RN, Martins da Silva JH, Singh B, Jiang J, Meyer EV, Santos F, et al. In silico identification and validation of a linear and naturally immunogenic B-cell epitope of the Plasmodium vivax malaria vaccine candidate merozoite surface protein-9. PLoS ONE. 2016;11:e0146951. CrossRefPubMedCentralPubMed
Tran TM, Oliveira-Ferreira J, Moreno A, Santos F, Yazdani SS, Chitnis CE, et al. Comparison of IgG reactivities to Plasmodium vivax merozoite invasion antigens in a Brazilian Amazon population. Am J Trop Med Hyg. 2005;73:244–55. PubMed
Ferreira AR, Singh B, Cabrera-Mora M, Magri De Souza AC, Queiroz Marques MT, Porto LC, et al. Evaluation of naturally acquired IgG antibodies to a chimeric and non-chimeric recombinant species of Plasmodium vivax reticulocyte binding protein-1: lack of association with HLA-DRB1*/DQB1* in malaria exposed individuals from the Brazilian Amazon. PLoS ONE. 2014;9:e105828. CrossRefPubMedCentralPubMed
Nogueira PA, Alves FP, Fernandez-Becerra C, Pein O, Santos NR, Pereira da Silva LH, et al. A reduced risk of infection with Plasmodium vivax and clinical protection against malaria are associated with antibodies against the N terminus but not the C terminus of merozoite surface protein 1. Infect Immun. 2006;74:2726–33. CrossRefPubMedCentralPubMed
The malEra Consultative Group on Monitoring E, Surveillance. A research agenda for malaria eradication: monitoring, evaluation, and surveillance. PLoS Med. 2011;8:e1000400. CrossRef
Bruce-Chwatt LJ, Draper CC, Dodge JS, Topley E, Voller A. Sero-epidemiological studies on population groups previously exposed to malaria. Lancet. 1972;299:512–5. CrossRef
Bruce-Chwatt LJ, Draper CC, Avramidis D, Kazandzoglou O. Sero-epidemiological surveillance of disappearing malaria in Greece. J Trop Med Hyg. 1975;78:194–200. PubMed
Carlos Jr EAC. Saúde e povos indígenas no Brasil: reflexões a partir do I Inquérito Nacional de Saúde e Nutrição Indígena. Cad Saude Publ. 2014;30:855–9. CrossRef
Sabchareon A, Burnouf T, Ouattara D, Attanath P, Bouharoun-Tayoun H, Chantavanich P, et al. Parasitologic and clinical human response to immunoglobulin administration in falciparum malaria. Am J Trop Med Hyg. 1991;45:297–308. PubMed
Longley RJ, Sattabongkot J, Mueller I. Insights into the naturally acquired immune response to Plasmodium vivax malaria. Parasitol. 2016;143:154–70. CrossRef
- A systematic review on malaria sero-epidemiology studies in the Brazilian Amazon: insights into immunological markers for exposure and protection
Pedro M. Folegatti
André M. Siqueira
Wuelton M. Monteiro
Marcus Vinícius G. Lacerda
Chris J. Drakeley
Érika M. Braga
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II