@article{fdi:010085983,
  title = {{I}dentification of factors associated with residual malaria transmission using school-based serological surveys in settings pursuing elimination},
  author = {{R}akotondramanga, {J}. {M}. and {V}igan-{W}omas, {I}. and {S}teinhardt, {L}. {C}. and {H}arimanana, {A}. and {R}avaoarisoa, {E}. and {R}asoloharimanana, {T}. {L}. and {R}azanatsiorimalala, {S}. and {W}esolowski, {A}. and {R}andrianarivelojosia, {M}. and {R}oche, {B}enjamin and {G}architorena, {A}ndres},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {T}argeted research on residual malaria transmission is important to improve strategies in settings pursuing elimination, where transmission reductions prove challenging. {T}his study aimed to detect and characterize spatial heterogeneity and factors associated with {P}lasmodium falciparum infections and exposure, {P}. falciparum apical membrane antigen 1 ({P}f{AMA}1) antibody ({A}b) response, in the {C}entral {H}ighlands of {M}adagascar ({CHL}). {M}ethods {F}rom {M}ay to {J}uly 2014, a cross-sectional school-based survey was carried out in 182 fokontany (villages) within 7 health districts of the {CHL}. {R}apid diagnostic tests ({RDT}s) and a bead-based immunoassay including {P}f{AMA}1 antigen biomarker were used to estimate malaria prevalence and seroprevalence, respectively. {L}ocal {M}oran's {I} index was used to detect spatial "hotspots". {R}emotely sensed environmental data-temperature, vegetation indices, land covers, and elevation-were used in multivariable mixed-effects logistic regression models to characterize factors associated with malaria infection and cumulative exposure. {R}esults {A}mong 6,293 school-children ages 2-14 years surveyed, {RDT} prevalence was low at 0.8% (95% {CI} 0.6-1.1%), while {P}f{AMA}1 {A}b seroprevalence was 7.0% (95% {CI} 6.4-7.7%). {H}otspots of {P}f{AMA}1 {A}b seroprevalence were observed in two districts ({A}nkazobe and {M}andoto). {S}eroprevalence increased for children living > 5 km from a health centre (adjusted odds ratio ({OR}) = 1.6, 95% {CI} 1.2-2.2), and for those experiencing a fever episode in the previous 2 weeks ({OR} 1.7, 95% {CI} 1.2-2.4), but decreased at higher elevation (for each 100-m increase, {OR} = 0.7, 95% {CI} 0.6-0.8). {A} clear age pattern was observed whereby children 9-10 years old had an {OR} of 1.8 (95% {CI} 1.2-2.4), children 11-12 years an {OR} of 3.7 (95% {CI} 2.8-5.0), and children 13-14 years an {OR} of 5.7 (95% {CI} 4.0-8.0) for seropositivity, compared with younger children (2-8 years). {C}onclusion {T}he use of serology in this study provided a better understanding of malaria hotspots and associated factors, revealing a pattern of higher transmission linked to geographical barriers in health care access. {T}he integration of antibody-assays into existing surveillance activities could improve exposure assessment, and may help to monitor the effectiveness of malaria control efforts and adapt elimination interventions.},
  keywords = {{M}alaria ; {P}lasmodium falciparum ; {A}ntibody ; {S}eroprevalence ; {AMA}1 ; {S}patial ; analysis ; {C}luster ; {E}pidemiology ; {M}adagascar ; {MADAGASCAR}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {21},
  numero = {1},
  pages = {242 [13 ]},
  year = {2022},
  DOI = {10.1186/s12936-022-04260-0},
  URL = {https://www.documentation.ird.fr/hor/fdi:010085983},
}