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About the Authors:
Benjamin F. Arnold
* E-mail: [email protected]
Affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, California, United States of America
Jeffrey W. Priest
Affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Katy L. Hamlin
Affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Delynn M. Moss
Affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
John M. Colford Jr
Affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, California, United States of America
Patrick J. Lammie
Affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Introduction
Efforts to monitor malaria transmission to inform control strategies increasingly use cross-sectional surveys to estimate transmission intensity from seroprevalence data based on malaria antibodies [1]–[8]. The approach has gained popularity because malaria antibody levels can be measured from dried blood spots [9], which are relatively easy to collect in the field in cross-sectional surveys, and this approach to estimating transmission intensity is far more cost effective and simple compared to alternative methods such as estimating the entomologic inoculation rate. Another major advantage of the approach compared to other low-cost methods, such as rapid diagnostic tests, is that the longevity of antibody responses makes them potentially more sensitive and informative measure of transmission in low-transmission environments [2]. A potential disadvantage of using antibody measures to estimate transmission intensity is that some antibody responses could saturate at a low transmission intensity, thus providing less useful information as a monitoring tool as transmission declines [1]. Nevertheless, serological measures of malaria infection have been proposed as a preferred diagnostic to measure community level transmission in the pre-elimination and elimination phases of malaria control [10].
Investigators have estimated malaria transmission intensity from cross-sectional prevalence surveys using seroconversion rates estimated with a reversible catalytic model [2]. Previous validation efforts have shown that the entomological inoculation rate – the main measure of transmission intensity – is strongly correlated with seroconversion rates estimated with a model fitted to cross-sectional data [1], [2]. However, to our...