A rapid immunochromatographic test for antibody detection as a new tool for monitoring malaria caused by Plasmodium vivax

Eliminating malaria caused by Plasmodium vivax remains a challenge, especially in areas of low transmission, where the high proportion of asymptomatic and subpatent infections limits the effectiveness of national eradication program control strategies. Antibody levels against parasite's antigens wane several months after treatment. Since the acquisition and maintenance of antimalarial humoral immunity depends on the infection, antibodies can serve as biomarkers of parasite exposure, emerging as a promising alternative for monitoring recent exposure to the parasite. We developed and validated a rapid diagnostic test that detects IgG (Ab-RDT) against two blood-stage antigens of P. vivax. The Ab-RDT identified a gradual decrease in antibody levels in treated individuals, suggesting that a positive test reflects recent exposure to the parasite or maintenance of infection. In agreement, a longitudinal study showed that a positive test, on Ab-RDT or ELISA, was strongly associated with the risk of subsequent detection of parasitemia by qPCR, highlighting the tests' usefulness in identifying individuals who were recently exposed or are more likely to be infected. The field performance of the Ab-RDT was 80.1% sensitivity and 89.4% specificity, using ELISA as a reference method, reinforcing the potential of antibody detection as a valuable tool to support malaria surveillance for P. vivax, especially for monitoring transmission in regions moving towards eradication, thereby enabling more strategic efforts in malaria control.

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Publication Details

Journal
PLoS neglected tropical diseases
Published
2026-06-26
DOI
https://doi.org/10.1371/journal.pntd.0014447
Primary Topic
Malaria Research and Control
Type
article
Field-Weighted Citation Impact
0.00

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article

A rapid immunochromatographic test for antibody detection as a new tool for monitoring malaria caused by Plasmodium vivax

Fabiana Fioravante Coelho, Michelle Oliveira-Silva, Dhélio B. Pereira, Renan P. Souza et al.
PLoS neglected tropical diseases
Malaria Research and Control
article

A rapid immunochromatographic test for antibody detection as a new tool for monitoring malaria caused by Plasmodium vivax

Fabiana Fioravante Coelho, Michelle Oliveira-Silva, Dhélio B. Pereira, Renan P. Souza, Bruno Vinícius Santos Valiate, Julia Ramos Sampaio, Lis Ribeiro do Valle Antonelli, Anielle de Pina-Costa, Gregório Guilherme Almeida, André M. Siqueira, Ricardo T. Gazzinelli, Camila Medeiros Costa, Ana Clara Gazzinelli-Guimarães, Alex F. Carvalho, A. D. Lemos Fernandes, Márcia Caldas de Castro, Irene da Silva Soares, Caroline Junqueira, Jéssica Karoline Augusta Oliveira, Alexia Martines Vieira Silva
article en

Abstract

Eliminating malaria caused by Plasmodium vivax remains a challenge, especially in areas of low transmission, where the high proportion of asymptomatic and subpatent infections limits the effectiveness of national eradication program control strategies. Antibody levels against parasite's antigens wane several months after treatment. Since the acquisition and maintenance of antimalarial humoral immunity depends on the infection, antibodies can serve as biomarkers of parasite exposure, emerging as a promising alternative for monitoring recent exposure to the parasite. We developed and validated a rapid diagnostic test that detects IgG (Ab-RDT) against two blood-stage antigens of P. vivax. The Ab-RDT identified a gradual decrease in antibody levels in treated individuals, suggesting that a positive test reflects recent exposure to the parasite or maintenance of infection. In agreement, a longitudinal study showed that a positive test, on Ab-RDT or ELISA, was strongly associated with the risk of subsequent detection of parasitemia by qPCR, highlighting the tests' usefulness in identifying individuals who were recently exposed or are more likely to be infected. The field performance of the Ab-RDT was 80.1% sensitivity and 89.4% specificity, using ELISA as a reference method, reinforcing the potential of antibody detection as a valuable tool to support malaria surveillance for P. vivax, especially for monitoring transmission in regions moving towards eradication, thereby enabling more strategic efforts in malaria control.

PLoS neglected tropical diseasesVol. 20(6)
Universidade Federal de Minas Gerais (BR), Universidade Federal Fluminense (BR), Universidade de São Paulo (BR), Instituto Federal Fluminense (BR), Harvard Global Health Institute (US), Fundação Oswaldo Cruz (BR)
Bill and Melinda Gates Foundation, Fundação de Amparo à Pesquisa do Estado de São Paulo, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Fundação de Amparo à Pesquisa do Estado de Minas Gerais
Good health and well-being
Openalex Percentile: Top 6%
Malaria Research and Control
DOIOpen Access PDFOpenAlex
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