Navigating parasite antigen genetic diversity in the design of Plasmodium vivax serological exposure markers for malaria.

Abstract

BACKGROUND: Plasmodium vivax poses a major obstacle to malaria elimination because it can lie dormant in the liver for weeks or months before reactivating and causing a relapse of infection. These dormant forms (hypnozoites) cannot be detected using standard diagnostics, but recent P. vivax exposure and by proxy, hypnozoite carriage, can be inferred using antibody-based tests (serological markers). In this study, we examined how genetic variation in P. vivax affects the utility of these antibody markers, and whether redesigned antigens could improve performance. METHODS: We analysed global P. vivax genetic data to assess variation in leading serological markers. Based on this, we produced ne..