4.8 Article

A saliva-based rapid test to quantify the infectious subclinical malaria parasite reservoir

Journal

SCIENCE TRANSLATIONAL MEDICINE
Volume 11, Issue 473, Pages -

Publisher

AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/scitranslmed.aan4479

Keywords

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Funding

  1. TEDCO Maryland Innovation Initiative award [120701]
  2. Bill & Melinda Gates Foundation [OPP 1054413]
  3. Chemical Biological Technologies Directorate from the Department of Defense Chemical and Biological Defense program through the Defense Threat Reduction Agency (DTRA)

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A large proportion of ongoing malaria parasite transmission is attributed to low-density subclinical infections not readily detected by available rapid diagnostic tests (RDTs) or microscopy. Plasmodium fakiparum gametocyte carriage is subclinical, but gametocytemic individuals comprise the parasite reservoir that leads to infection of mosquitoes and local transmission. Effective detection and quantification of these carriers can help advance malaria elimination strategies. However, no point-of-need (PON) RDTs for gametocyte detection exist, much less one that can perform noninvasive sampling of saliva outside a clinical setting. Here, we report on the discovery of 35 parasite markers from which we selected a single candidate for use in a PON RDT. We performed a cross-sectional, multi-omics study of saliva from 364 children with subclinical infection in Cameroon and Zambia and produced a prototype saliva-based PON lateral flow immunoassay test for P. fakiparum gametocyte carriers. The test is capable of identifying submicroscopic carriage in both clinical and nonclinical settings and is compatible with archived saliva samples.

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