Variation in exposure to Anopheles gambiae salivary gland peptide (gSG6-P1) across different malaria transmission settings in the western Kenya highlands

Abstract

Background: The existing metrics of malaria transmission are limited in sensitivity under low transmission intensity. Robust surveillance systems are needed as interventions to monitor reduced transmission and prevention of rapid reintroduction. Serological tools based on antibody responses to parasite and vector antigens are potential tools for transmission measurements. The current study sought to evaluate antibody responses to Anopheles gambiae salivary gland peptide (gSG6- P1), as a biomarker of human exposure to Anopheles bites, in different transmission settings and seasons. The comparison between anti-MSP-1(19) IgG immune responders and non-responders allowed exploring the robustness of the gSG6-P1 peptide as a surveillance tool in an area of decreasing malaria transmission.

Methods: Total IgG levels to gSG6-P1 were measured in an age-stratified cohort (< 5, 5-14 and ≥ 15 years) in a total of 1,366 participants from three localities in western Kenya [Kisii (hypoendemic), Kakamega (mesoendemic), and Kombewa (hyperendemic)] including 607 sera that were additionally tested for MSP-1(19) specific responses during a low and a high malaria transmission seasons. Antibody prevalence and levels were compared between localities with different transmission intensities. Regression analysis was performed to examine the association between gSG6-P1 and MSP-1(19) seroprevalence and parasite prevalence.

Result: Seroprevalence of gSG6-P1 in the uphill population was 36% while it was 50% valley bottom (χ(2) = 13.2, df = 1, p < 0.001). Median gSG6-P1 antibody levels in the Valley bottom were twice as high as that observed in the uphill population [4.50 vs. 2.05, p < 0.001] and showed seasonal variation. The odds of gSG6-P1 seropositives having MSP-1(19) antibodies were almost three times higher than the odds of seronegatives (OR = 2.87, 95% CI [1.977, 4.176]). The observed parasite prevalence for Kisii, Kakamega and Kombewa were 4%, 19.7% and 44.6% whilst the equivalent gSG6-P1 seroprevalence were 28%, 34% and 54%, respectively.

Conclusion: The seroprevalence of IgG to gSG6-P1 was sensitive and robust in distinguishing between hypo, meso and hyper transmission settings and seasonal fluctuations.

Figure 1

Shows the Map of the study sites.

Figure 2

Shows Bar graphs of specific Median humoral responses to gSG6-P1 in different localities and seasons.A: responses between Uphill (n = 322) and valley (n = 422) residents. Mann Whitney: P = 0.0002. B: responses between and Rainy (n = 360) Dry (n = 384) seasons. Mann Whitney: P = 0.028. Error Bars show inter-quartile ranges (Lower 25 %- Upper 75 %).

Figure 3

A scatter plot showing the trends of gSG6-P1 and MSP-1₁₉seroprevalence together with P. falciparum with age at different locations. A (Uphill n = 232), B (valley bottom n = 375) and C (Total population n = 607).

Figure 4

A bar graph showing gSG6-P1 seroprevalence and their respective parasite prevalence in different endemic localities. Kisii (n = 222), Kakamega (n = 203) and Kombewa (n = 202).