Serological markers for enhanced malaria surveillance from an elimination point of view: A narrative review

Abstract

Malaria continues to pose a significant global health challenge despite a significant achievement in control and elimination in certain areas. Accurate and timely diagnosis is crucial for effective disease management and control, and finally leading to elimination. However, microscopy and rapid diagnostic tests (RDTs) have traditionally been the primary malaria diagnostic tools used globally, with certain shortcomings, including their limited sensitivity, specificity, and inability to identify asymptomatic infections. Serological markers have emerged as promising alternatives in malaria serosurveillance, particularly in countries where targets have already been set for elimination. This review highlights the advantages of serological markers over conventional diagnostic techniques and discusses some of the most promising serological markers against Plasmodium species-specific antigens. The implementation of serosurveillance, coupled with the utilization of these serological markers represents a transformative shift in malaria surveillance. By capitalizing on the immune memory of individuals, serosurveillance also enables the identification of recent and past infections. This approach is particularly valuable in low- transmission settings and for tracking changes in malaria prevalence over time. While recognizing the use of serological markers across various global contexts, this review predominantly emphasizes their significance within the framework of India.

Keywords

Microscopy / Rapid diagnostic tests / Serosurveillance / Serological markers / Sensitivity / Specificity

Conflict of interest statement

The authors declare no conflicts of interests.

Funding

The authors received no extramural funding for the study.

Authors’ contributions

NN, PKB, and VM conceptualized the study; VM did the literature review; VM and KV analysed and drafted the manuscript; NN, PKB, and KV critically reviewed the manuscript. All authors read and approved the final manuscript.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Acknowledgments

The authors would like to thank the University Grants Commission (UGC) for VM fellowship, and ICMR-NIMR for Institutional support.

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