Field evaluation of a Point-of-Contact device for P. falciparum malaria serosurveillance

As the number of malaria cases decline, detection of malaria transmission and population surveillance increasingly require more demanding and costly detection tests (e.g. PCR, LAMP), and much larger population surveys are required to detect ongoing transmission. An additional problem is access to these populations and resources available in the field. High-risk populations typically reside in remote locations that are difficult to access and have limited infrastructures. The availability of a simple, low-cost POC test for the detection of recent malaria exposure usable by community health workers would facilitate malaria surveillance and allow the estimation and reporting of the malaria burden to enable better planning of interventions and services. Work at the Burnet Institute (led by Philippe Boeuf and James Beeson) has developed an innovative POC test that detects antimalarial antibodies as markers of current or recent past exposure to Plasmodium falciparum (within the past few weeks to months). This test incorporates four antibody parameters into a lateral flow format and results are read by an FDA-compliant hand-held POC test reader to maximize sensitivity and specificity. The hand-held device also stores data collected for subsequent upload into surveillance databases. Using banked samples, this POC test provided a sensitivity of 94.3% and a specificity of 100% for the detection of seropositive individuals when compared to ELISA results obtained in the laboratory. Now, the POC test needs to be evaluated in the field.

This POC device will be evaluated on-site during the village surveys on a sub-set of 300 individuals (n=75 from each village). POC results will be compared against ELISA results, currently considered as the gold-standard for serosurveillance. Because the test combines low-cost, proven and widely-used lateral-flow technology with a small, battery-operated hand-held reader, this proposal will evaluate not only the sensitivity and specificity of the POC test but also assess its user-friendliness. By identifying individuals recently exposed and/or currently infected, this device could strengthen malaria eradication efforts by estimating transmission intensity of P. falciparum malaria as well as predicting malaria risk at the individual and population level.

Surveillance

May 2019 — Oct 2023

$15,000

Myanmar

Australian Centre for Research Excellence in Malaria Elimination (ACREME)