Abstract
IntroductionIn the era of malaria elimination and eradication, drug-based and vaccine-based approaches to reduce malaria transmission are receiving greater attention. Such interventions require assays that reliably measure the transmission of Plasmodium from humans to Anopheles mosquitoes.MethodsWe compared two commonly used mosquito feeding assay procedures: direct skin feeding assays and membrane feeding assays. Three conditions under which membrane feeding assays are performed were examined: assays with i) whole blood, ii) blood pellets resuspended with autologous plasma of the gametocyte carrier, and iii) blood pellets resuspended with heterologous control serum.Results930 transmission experiments from Cameroon, The Gambia, Mali and Senegal were included in the analyses. Direct skin feeding assays resulted in higher mosquito infection rates compared to membrane feeding assays (odds ratio 2.39, 95% confidence interval 1.94–2.95) with evident heterogeneity between studies. Mosquito infection rates in membrane feeding assays and direct skin feeding assays were strongly correlated (p<0.0001). Replacing the plasma of the gametocyte donor with malaria naïve control serum resulted in higher mosquito infection rates compared to own plasma (OR 1.92, 95% CI 1.68–2.19) while the infectiousness of gametocytes may be reduced during the replacement procedure (OR 0.60, 95% CI 0.52–0.70).ConclusionsDespite a higher efficiency of direct skin feeding assays, membrane feeding assays appear suitable tools to compare the infectiousness between individuals and to evaluate transmission-reducing interventions. Several aspects of membrane feeding procedures currently lack standardization; this variability makes comparisons between laboratories challenging and should be addressed to facilitate future testing of transmission-reducing interventions.
Highlights
In the era of malaria elimination and eradication, drug-based and vaccine-based approaches to reduce malaria transmission are receiving greater attention
Not all gametocytes that are ingested by mosquitoes result in sporozoites in the salivary glands, and the transmission of malaria embodies more than just the epidemiology of gametocytes
Antimalarial drugs and vaccines that target the transmission stages of malaria parasites are high on the priority list of the research agenda for malaria eradication [59,60]
Summary
In the era of malaria elimination and eradication, drug-based and vaccine-based approaches to reduce malaria transmission are receiving greater attention. Such interventions require assays that reliably measure the transmission of Plasmodium from humans to Anopheles mosquitoes. Once ingested by a blood feeding female Anopheles mosquito, male and female gametocytes become activated gametes that fuse to form zygotes. The oocyst enlarges and matures over time and ruptures, after approximately 11–16 days for P. falciparum [1], to release sporozoites that migrate to the mosquito salivary glands. Not all gametocytes that are ingested by mosquitoes result in sporozoites in the salivary glands, and the transmission of malaria embodies more than just the epidemiology of gametocytes
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