Abstract
BackgroundSeveral refugee settlements in Bangladesh have provided housing and medical care for the forcibly-displaced Myanmar nationals (FDMN, also known as Rohingya) population. The identification of malaria infection status in the refugee settlements is useful in treating infected persons and in developing malaria prevention recommendations. Assays for Plasmodium antigens and human IgG against Plasmodium parasites can be used as indicators to determine malaria infection status and exposure.MethodsDried blood spot (DBS) samples (N = 1239) from a household survey performed April–May 2018 in three settlements in Cox’s Bazar district, Bangladesh were utilized for a sample population of children from ages 1–14 years of age. The samples were tested using a bead-based multiplex antigen assay for presence of the pan-Plasmodium antigen aldolase as well as Plasmodium falciparum histidine rich protein 2 (HRP2). A bead-based multiplex assay was also used to measure human IgG antibody response to P. falciparum, Plasmodium malariae, and Plasmodium vivax merozoite surface protein 1 antigen (MSP1) isoforms, and P. falciparum antigens LSA1, CSP, and GLURP-R0.ResultsThere were no detectable Plasmodium antigens in any samples, suggesting no active malaria parasite infections in the tested children. IgG seroprevalence was highest to P. vivax (3.1%), but this was not significantly different from the percentages of children antibody responses to P. falciparum (2.1%) and P. malariae (1.8%). The likelihood of an anti-Plasmodium IgG response increased with age for all three malaria species. Evidence of exposure to any malaria species was highest for children residing 8–10 months in the settlements, and was lower for children arriving before and after this period of time.ConclusionsAbsence of Plasmodium antigen in this population provides evidence that children in these three Bangladeshi refugee settlements did not have malaria at time of sampling. Higher rates of anti-malarial IgG carriage from children who were leaving Myanmar during the malaria high-transmission season indicate these migrant populations were likely at increased risk of malaria exposure during their transit.
Highlights
Several refugee settlements in Bangladesh have provided housing and medical care for the forciblydisplaced Myanmar nationals (FDMN, known as Rohingya) population
When generating seroprevalence estimates for any antibodies to any malaria species, the overall study population had an estimated seroprevalence of 7.3% with no single camp having a seroprevalence to any anti-malaria Immunoglobulin G (IgG) above 8.9%
In this study, blood samples were assayed from children residing in three refugee settlements in southeast Bangladesh for Plasmodium antigens as well as IgG antibodies against malaria
Summary
Several refugee settlements in Bangladesh have provided housing and medical care for the forciblydisplaced Myanmar nationals (FDMN, known as Rohingya) population. Assays for Plasmodium antigens and human IgG against Plasmodium parasites can be used as indicators to determine malaria infection status and exposure. Parasites belonging to the genus Plasmodium are the causative agents of malaria, and a significant burden to humanity with nearly half of the human population at risk for infection. In dealing with Plasmodium infections, the human immune system has adapted to recognize numerous Plasmodium antigens to be targeted for humoral response [4, 5]. Plasmodium exposure even at a young age has the potential to induce a decades-long, or even life-long, antibody response. For P. falciparum, numerous antigens are known to induce more “short-lived” IgG responses, an presence of IgG against these antigens indicates more recent P. falciparum exposure [7, 9, 10]
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