Abstract
Monitoring malaria prevalence in humans, as well as vector populations, for the presence of Plasmodium, is an integral component of effective malaria control, and eventually, elimination. In the field of human diagnostics, a major challenge is the ability to define, precisely, the causative agent of fever, thereby differentiating among several candidate (also non-malaria) febrile diseases. This requires genetic-based pathogen identification and multiplexed analysis, which, in combination, are hardly provided by the current gold standard diagnostic tools. In the field of vectors, an essential component of control programs is the detection of Plasmodium species within its mosquito vectors, particularly in the salivary glands, where the infective sporozoites reside. In addition, the identification of species composition and insecticide resistance alleles within vector populations is a primary task in routine monitoring activities, aiming to support control efforts. In this context, the use of converging diagnostics is highly desirable for providing comprehensive information, including differential fever diagnosis in humans, and mosquito species composition, infection status, and resistance to insecticides of vectors. Nevertheless, the two fields of human diagnostics and vector control are rarely combined, both at the diagnostic and at the data management end, resulting in fragmented data and mis- or non-communication between various stakeholders. To this direction, molecular technologies, their integration in automated platforms, and the co-assessment of data from multiple diagnostic sources through information and communication technologies are possible pathways towards a unified human vector approach.
Highlights
Malaria is one of the most widespread infectious diseases, both in terms of geographical distribution and human cases
A novel TaqMan assay was recently developed, capable of detecting the infective stage of the Plasmodium parasite by measuring the mRNA levels that are expressed at the infective parasite stage, the sporozoites. This method does not require head/thorax dissections, and can be used in mosquito pools, in single or multiplex formats, i.e., targeting additional markers expressed in different tissues, such as detoxification enzymes associated with insecticide resistance [65]
A recent version of the system makes use of 12 chambers which, in addition to 3-plex color multiplexing can give, in future, rise to a 36-plex detection configuration, especially for species identification, pathogen detection, and insecticide resistances. It has been recently used in some validation studies in Senegal and Sudan using a multiplex tropical infection panel, and is under development for the first proof of principle using mosquito samples [80]
Summary
Malaria is one of the most widespread infectious diseases, both in terms of geographical distribution and human cases. For elimination, future diagnostic and treatment tools and strategies must undoubtedly be able to identify and aim at this target group as well, so as to clear malaria parasites from asymptomatic carriers This will be strategically achieved through the adaptability of health systems and available tools, to prevent, detect, and treat the clinical cases, but every malaria infection, including the aforementioned asymptomatic ones. The One Health, as a term, refers to “the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, plants and our environment” [12,13] As this special issue focuses on malaria, the authors directed their analysis towards this particular disease from the human and the vectors’ perspective as two branches of the One. Health approach. The technologies that are reviewed and the interconnection that is suggested (i) between the technologies (vertically) and (ii) between human and vector diagnostics (horizontally) are applicable for other vector-borne diseases as well, the reader is urged to consider the impact and implications on the entire health system, rather than a single health facility/sentinel site level
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