Abstract
The last decade has witnessed a steady reduction of the malaria burden worldwide. With various countries targeting disease elimination in the near future, the popular parasite infection or entomological inoculation rates are becoming less and less informative of the underlying malaria burden due to a reduced number of infected individuals or mosquitoes at the time of sampling. To overcome such problem, alternative measures based on antibodies against specific malaria antigens have gained recent interest in malaria epidemiology due to the possibility of estimating past disease exposure in absence of infected individuals. This paper aims then to review current mathematical models and corresponding statistical approaches used in antibody data analysis. The application of these models is illustrated with three data sets from Equatorial Guinea, Brazilian Amazonia region, and western Kenyan highlands. A brief discussion is also carried out on the future challenges of using these models in the context of malaria elimination.
Highlights
Malaria is a global health problem with more than 1 billion people estimated to be at risk
These estimates suggested a reduction of 84% in malaria transmission intensity, which is in close agreement with a reduction in seroconversion rate (SCR) of 89% estimated from the superinfection model (Table 2)
Serology-based analysis needs to be complemented with any additional data available that would provide an external validation to the serological findings
Summary
Malaria is a global health problem with more than 1 billion people estimated to be at risk. Alternative methods exist in the literature, the estimation of the entomological inoculation rate is in general a laborious and time-consuming task in low transmission settings owing to a low number of infected mosquitoes [11] It is affected by seasonal effects and mosquito population dynamics and the degree of mosquito attractiveness to the human hosts or the chemicals used in the study [11]. Special attention will be given to current methods aiming to define seropositivity and the subsequent mathematical models for estimating SCR under different epidemiological settings: stable malaria transmission intensity, abrupt reduction in SCR due to a malaria control intervention, change in SCR due to a putative age-dependent behavior, detection of migration effects, and detection of individual level heterogeneity through a set of covariates. Future analytical challenges will be discussed in the context of malaria elimination and eradication
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