约氏疟原虫与伯氏疟原虫诱导感染小鼠产生保护性抗体的特点研究

比较约氏疟原虫(Plasmodium yoelii)与伯氏疟原虫(Plasmodium berghei)再次感染模型特异性抗体产生的差异,追溯相应虫体抗原的表达特点。建立约氏疟原虫与伯氏疟原虫再次感染鼠疟模型,ELISA检测特异性抗体水平;Western Blot检测血清中优势抗体反应特点;检测两种虫株的MSP-1重组蛋白与免疫血清的反应程度;质谱鉴定伯氏疟原虫诱导免疫血清中优势抗体的抗原特点。ELISA表明小鼠免疫血清能够与相对应虫株蛋白产生特异性反应,二次感染后的免疫血清具有抗体产生增强的现象;免疫血清与重组的MSP-1蛋白具有较好的反应性,反应水平具有种属差异性。与约氏疟原虫产生以抗MSP-1抗体为主的反应模式不同,伯氏疟原虫免疫血清还增加了分子量55 kD的反应条带,通过蛋白质谱鉴定提示可能是PbANKA_0702800,PbANKA_020920,PbANKA_110220等疟原虫表面蛋白。结果表明,抗疟原虫有效抗体的产生在宿主抵抗疟原虫感染尤其是再次感染的过程中发挥至关重要的作用。     

脾细胞不同组分在鼠疟感染中相互作用的研究

探讨约氏疟原虫感染后脾细胞不同组分间相互作用对免疫分子分泌的影响。以约氏疟原虫腹腔感染DBA/2小鼠,采用ELISA和Griess实验分别检测感染后第3 d小鼠全脾细胞、巨噬细胞和悬浮细胞培养上清中IFN-γ和NO水平。在不同培养时间组,全脾细胞IFN-γ和NO分泌水平均明显高于单纯巨噬细胞或悬浮细胞;全脾细胞48 h和72 h培养组的IFN-γ水平明显高于24 h培养组,并且其NO的分泌水平随培养时间的延长而显著升高。脾细胞不同组分间的相互作用可明显促进其免疫分子的分泌;NO的分泌依赖于IFN-γ的诱导效应。     

BALB/c小鼠感染不同疟原虫CD4＋ Th应答和凋亡特点的比较研究

探讨不同疟原虫感染BALB/c小鼠的免疫应答特点。BALB/c小鼠经腹腔注射致死型约氏疟原虫（P.y17XL）和夏氏疟原虫（P.cAS）感染的红细胞,计数红细胞感染率;ELISA动态检测感染小鼠脾细胞培养上清中IFN-γ和IL-4水平;流式细胞术检测脾中CD4＋T细胞凋亡数量。约氏疟原虫（P.y17XL）感染早期,小鼠原虫血症持续上升;IFN-γ和IL-4分泌水平仅在感染后第3天出现一过性有意义的升高,而且峰值较低;脾中CD4＋T细胞大量凋亡,小鼠全部死亡;而夏氏疟原虫（P.cAS）感染小鼠,原虫血症上升缓慢;IFN-γ分泌水平在感染后第5天达峰值;IL-4分泌水平在感染后第10天达峰值,且峰值较高维持时间较长;脾中CD4＋T细胞凋亡细胞于感染后8 d出现有意义升高,小鼠全部存活。抗疟保护性免疫有赖于Th1和Th2型免疫应答的有效建立和协调过渡,感染期间CD4＋T细胞凋亡的时相和数量可能是影响免疫应答的强度或引起宿主免疫抑制的原因,从而影响宿主疟原虫感染的结局。     

旋毛形线虫预感染对夏氏疟原虫感染BALB/c小鼠Th细胞变化的影响

为研究预感染旋毛形线虫后BALB/c小鼠抵御夏氏疟原虫攻击感染的能力,实验组(TPC)分别在小鼠感染旋毛形线虫1 w(TPC1)和3 w(TPC3)后感染夏氏疟原虫,对照组(PC)单独感染夏氏疟原虫,观察小鼠原虫血症及体重的变化,并采用Real-Time RCR扩增法分析转录因子T-bet和Gata-3表达水平的消长。与PC组相比,TPC1组原虫血症峰值降低,T-bet表达水平升高,Gata-3表达水平降低;TPC3组原虫血症出现时间推迟,峰值升高,T-bet表达水平降低,Gata-3表达水平升高;TPC组体重均下降,TPC组与PC组均于感染后25 d左右自愈。旋毛虫预感染使小鼠对疟原虫的抗感染能力增强,但混合感染并不影响宿主最终清除疟原虫的能力。     

不同毒力疟原虫感染早期根治性治疗对再感染体液免疫应答的影响

为探讨不同毒力疟原虫感染早期根治性治疗对再感染体液免疫应答的影响,用致死型和非致死型约氏疟原虫感染DBA/2小鼠,感染后3 d进行根治性治疗,并于初次感染后90 d进行再感染。计数红细胞感染率和检测再感染前（0 d）和再感染后（1、3、5 d）不同时间点脾细胞中活化性B细胞百分率以及血清中IgG、IgG1和IgG2 a水平,结果显示,再感染后2组小鼠均出现短暂的低水平虫体血症,再感染后第3天活化性B细胞、IgG、IgG1和IgG2 a均出现有意义的升高,但在每一相同检测时间点,2组小鼠的虫体血症、活化性B细胞百分率、IgG、IgG1和IgG2 a水平均没有显著差异。这些结果表明,不同毒力疟原虫感染早期的根治性治疗并不影响宿主在再感染时产生有效的体液免疫应答,强毒株原虫感染也能获得与弱毒株相同的可抵御再感染的能力。     

不同浓度血府逐瘀汤含药血清对大鼠血管平滑肌细胞增殖、迁移及侵袭的影响

目的观察不同浓度血府逐瘀汤含药血清对大鼠主动脉平滑肌细胞（VSMCs）增殖、迁移及侵袭的影响,以及其生成一氧化氮（NO）的情况。方法用MTT法观察VSMCs的增殖,Transwell小室法观察VSMCs的迁移、侵袭,并检测培养上清液一氧化氮（NO）的含量。结果与空白对照组比较,5%血府逐瘀汤组能显著促进VSMCs的增殖（P〈0.05）,20%,30%血府逐瘀汤组能显著抑制VSMCs的增殖（P〈0.05）;与空白对照组比较,培养48 h的培养上清液中,血府逐瘀汤组的NO水平有显著升高（P〈0.01）,且与血府逐瘀汤含药血清的浓度有剂量依赖关系。结论低浓度（〈10%）血府逐瘀汤含药血清有促进VASMCs增殖和迁移、侵袭的作用,高浓度（〉10%）血府逐瘀汤含药血清有抑制VASMCs增殖、迁移和侵袭的作用,其作用可能与上清液的NO水平有关。     

蛋氨酸脑啡肽对疟疾感染鼠一氧化氮产生的研究

探讨蛋氨酸-脑啡肽(M-ENK)对约氏疟原虫感染早期小鼠脾细胞分泌一氧化氮(NO)的免疫调节效应及相关机制。以不同浓度的M-ENK(单独或与LPS合用)与疟原虫感染后第3dBALB/c或DBA/2小鼠的脾细胞共同培养,通过Griess反应和ELISA法分别检测其上清中NO和IFN-γ的水平。脾细胞与浓度为10-10或10-11mol/L的M-ENK培养后,NO的分泌水平明显升高,并且与LPS联合刺激后其NO的产生进一步增强,但IFN-γ水平均未出现有意义的变化。提示浓度为10-10或10-11mol/L的M-ENK能够促进约氏疟原虫感染小鼠脾细胞NO的产生,该作用与IFN-γ活化巨噬细胞路径可能无关,同时M-ENK对LPS的刺激效应也具有强化作用。     

致死型夏氏疟原虫感染BALB/c小鼠CD4~＋ CD25~＋ Foxp3~＋调节性T细胞在Th2免疫应答极化中的作用研究

为探讨CD4＋ CD25＋ Foxp3＋调节性T细胞（Treg细胞）在疟疾感染过程中对Th2极化的调控作用,利用Treg细胞消除的致死型夏氏疟原虫（Plasmodium chabaudi chabaudi AS,P.c chabaudi AS）感染鼠疟模型进行研究。结果显示,对照组小鼠在感染后8 d原虫血症达到峰值40.5%,随后迅速下降,于感染后18 d小鼠自愈。相比,Treg细胞消除组于感染后10 d,原虫血症水平迅速上升至32%,随后小鼠相继死亡。在感染后8～10 d,Treg细胞消除小鼠脾脏CD4＋ CD25＋ Foxp3＋细胞占CD4＋细胞百分比含量明显低于对照组。同时,血清疟原虫特异性抗体IgG1和IgG2a水平均明显降低。结果提示,P.c chabaudi AS感染中CD4＋ CD25＋ Foxp3＋细胞参与调控Th2型免疫应答的极化,进而干预疟原虫清除。     

外源腐胺促进苹果果皮花青苷积累的效应

为了探讨外源施加腐胺对苹果果皮花青苷合成相关基因的调控效应和果实着色的影响,摘袋当天对苹果品种红富士（Malusdomestica Borkh．‘Red Fuji’）果实喷施50mg·L^-1腐胺（putrescine,Put）,利用分光光度计和高效液相色谱仪分别对苹果果皮花青苷含量及其组成进行了分析：利用实时荧光定量PCR法检测了转录调节因子MYB1和5个花青苷合成结构基因的转录水平。结果表明：（1）外源喷施Put对于苹果果皮中花青苷的积累具有明显的促进效应,在果实采收时,处理组果皮中的花青苷含量为对照组的1．9倍：（2）处理果实的果皮中含有矢车菊素阿拉伯糖苷（cyaniding-3-arabinoside,Cy-3-ara）,而在相同条件下,对照组中未能检测到Cy-3-ara;（3）Put处理对于转录调节因子MYB1和类黄酮3,5-糖苷转移酶（UDP-glycose：flavonoid 3-O-glycosyltransferase,UFGT）基因的转录有明显的促进作用,摘袋后第1天和第3天,Put处理组的MYB1转录水平分别为对照组的1．6和2．0倍,UFG7变化趋势与MYB1类似,查耳酮异构酶（chalcone isomerase,CHI）、花青素苷元还原酶（anthocyanidin reductase,ANR）和无色花青素加双氧酶（leucoanthocyanidin dioxygenase,LDOX）等基因的转录水平在Put处理初期也表现为明显上升,特别是LDOx基因,其转录水平在处理后第1天和第3天分别达到对照的10-2和3．8倍。在所研究的基因中,二氢类黄酮还原酶（dihydrofIavonol 4-reductase,DFR）基因是唯一一个经Put处理后其转录水平受到强烈抑制的基因,且这种抑制作用在摘袋后第3天最为明显,对照组的DFR转录水平为Put处理组的2．3倍。     

丙型肝炎病毒E1蛋白活化MAPK／ERK信号通路促进肝癌细胞增殖

目的研究丙型肝炎病毒（hepatitisCvirus,HCV）编码蛋白E1的生物学功能。方法分别构建编码HCV重要蛋白E1、E2、NS3、NS5a、NS5b的腺病毒载体Ad—E1、Ad—E2、Ad—NS3、Ad—NS5a、Ad—NS5b;将重组并包装的腺病毒分别感染SMMC-7721细胞,测定感染滴度,通过RT—PCR方法在转录水平鉴定HCVE1、E2、NS3、NS5a、NSSb的表达,用Western印迹在蛋白水平鉴定E1蛋白的表达。腺病毒感染SMMC-7721细胞后,通过细胞增殖实验筛选生物学功能最明显的蛋白。将筛选到的Ad—E1感染SMMC-7721细胞,用MTS、结晶紫、细胞周期实验观察体外过表达E1蛋白对感染细胞增殖的影响;Western印迹检测p-ERK、ERK的表达;RT—PCR检测c—Myc、cyclinD1、c—Jun、c．Fos基因的表达。结果成功扩增了能够编码HCV重要蛋白E1、E2、NS3、NS5a、NS5b的高滴度腺病毒Ad—E1、Ad—E2、Ad—NS3、Ad—NS5a、Ad—NS5b,并且通过RT—PCR方法在转录水平鉴定了目的基因的表达,Western印迹方法在蛋白水平鉴定了E1蚩白的表达。通过细胞计数、MTS、结晶紫实验证实Ad—E1感染组细胞较对照组增殖速度加快,细胞周期显示Ad-E1感染组细胞34．38％处于S期,明显高于Ad—GFP（27．32％）（P〈0．05）对照组;Ad-E1感染绢p-ERK蛋白表达量增高,同时与细胞增殖相关的MAPK／ERK下游基因转录水平上凋。结论体外过表达HCVE1蛋白可以明显促进SMMC-7721细胞的增殖,其促增殖作用可能与MAPK／ERK信号通路的活化相关。     

Genetic polymorphism and natural selection in the malaria parasite Plasmodium falciparum.

We have studied the genetic polymorphism at 10 Plasmodium falciparum loci that are considered potential targets for specific antimalarial vaccines. The polymorphism is unevenly distributed among the loci; loci encoding proteins expressed on the surface of the sporozoite or the merozoite (AMA-1, CSP, LSA-1, MSP-1, MSP-2, and MSP-3) are more polymorphic than those expressed during the sexual stages or inside the parasite (EBA-175, Pfs25, PF48/45, and RAP-1). Comparison of synonymous and nonsynonymous substitutions indicates that natural selection may account for the polymorphism observed at seven of the 10 loci studied. This inference depends on the assumption that synonymous substitutions are neutral, which we test by analyzing codon bias and G+C content in a set of 92 gene loci. We find evidence for an overall trend towards increasing A+T richness, but no evidence for mutation bias. Although the neutrality of synonymous substitutions is not definitely established, this trend towards an A+T rich genome cannot explain the accumulation of substitutions at least in the case of four genes (AMA-1, CSP, LSA-1, and PF48/45) because the Gleft and right arrow C transversions are more frequent than expected. Moreover, the Tajima test manifests positive natural selection for the MSP-1 and, less strongly, MSP-3 polymorphisms; the McDonald-Kreitman test manifests natural selection at LSA-1 and PF48/45. We conclude that there is definite evidence for positive natural selection in the genes encoding AMA-1, CSP, LSA-1, MSP-1, and Pfs48/45. For four other loci, EBA-175, MSP-2, MSP-3, and RAP-1, the evidence is limited. No evidence for natural selection is found for Pfs25.     

Fetal immune responses to Plasmodium falciparum antigens in a malaria-endemic region of Cameroon

Plasmodium falciparum infection during pregnancy can lead to the transplacental passage of malarial Ags that are capable of inducing acquired immune responses in the fetus. Studies have identified cytokines produced by malaria-specific cord blood (CB) T cells, but information on fetal B cells is limited. Thus, CB mononuclear cells from 120 Cameroonian newborns were cultured for 7 days in vitro and supernatants were assessed by ELISA for Abs to an extract of malarial schizonts (MA), recombinant apical merozoite Ag 1 (AMA-1), the 42-kDa C-terminal region of merozoite surface protein 1 (MSP-1(42)), a B epitope of ring-infected erythrocyte surface Ag (RESA), and the dominant B epitope of the circumsporozoite protein (CSP). Only 12% of supernatants contained IgM to MA but 78% had IgG to one or more malarial Ags, with 53% having IgG to AMA-1, 38% to MSP-1(42), 3% to RESA, and 0% to CSP. The Abs to AMA-1 and MSP-1(42) were predominantly IgG1 and IgG3. CB mononuclear cells were also tested for the ability to secrete cytokines in response to MA and a pool of conserved MSP-1 T cell epitopes. Among the Ag-reactive samples, 39.3% produced only Th2-type cytokines, whereas 60.6% produced a combination of Th1- and Th2-type cytokines. Although a Th2 bias was observed, the in utero cytokine environment was adequate to support isotype switching to cytophilic IgGs, the isotypes that are protective in adults. Because many infants living in a low transmission area are born with malaria-specific B and T cells, the influence of in utero priming on neonatal immunity merits further investigation.     

Low antibodies against Plasmodium falciparum and imbalanced pro-inflammatory cytokines are associated with severe malaria in Mozambican children: a case-control study

ABSTRACT: BACKGROUND: The factors involved in the progression from Plasmodium falciparum infection to severe malaria (SM) are still incompletely understood. Altered antibody and cellular immunity against P. falciparum might contribute to increase the risk of developing SM. METHODS: To identify immune responses associated with SM, a sex- and age-matched case-control study was carried out in 134 Mozambican children with SM (cerebral malaria, severe anaemia, acidosis and/or respiratory distress, prostration, hypoglycaemia, multiple seizures) or uncomplicated malaria (UM). IgG and IgM against P. falciparum lysate, merozoite antigens (MSP-119, AMA-1 and EBA-175), a Duffy binding like (DBL)-alpha rosetting domain and antigens on the surface of infected erythrocytes were measured by ELISA or flow cytometry. Plasma concentrations of IL-12p70, IL-2, IFN-gamma, IL-4, IL-5, IL-10, IL-8, IL-6, IL- 1beta, TNF, TNF-beta and TGF-beta1 were measured using fluorescent bead immunoassays. Data was analysed using McNemar's and Signtest. RESULTS: Compared to UM, matched children with SM had reduced levels of IgG against DBLalpha (P < 0.001), IgM against MSP-119 (P = 0.050) and AMA-1 (P = 0.047), TGF-beta1 (P <0.001) and IL-12 (P = 0.039). In addition, levels of IgG against P. falciparum lysate and IL-6 concentrations were increased (P = 0.004 and P = 0.047, respectively). Anti-DBLalpha IgG was the only antibody response associated to reduced parasite densities in a multivariate regression model (P = 0.026). CONCLUSIONS: The lower levels of antibodies found in children with SM compared to children with UM were not attributable to lower exposure to P. falciparum in the SM group. IgM against P. falciparum and specific IgG against a rosetting PfEMP1 domain may play a role in the control of SM, whereas an imbalanced pro-inflammatory cytokine response may exacerbate the severity of infection. A high overlap in symptoms together with a limited sample size of different SM clinical groups reduced the power to identify immunological correlates for particular forms of SM.     

A multigene family that interacts with the amino terminus of plasmodium MSP-1 identified using the yeast two-hybrid system

Merozoite surface protein 1 (MSP-1) is a high-molecular-weight protein expressed on the surface of the malaria merozoite in a noncovalent complex with other protein molecules. MSP-1 undergoes a series of proteolytic processing events, but no precise biological role for the various proteolytic fragments of MSP-1 or for the additional proteins present in the complex is known. Through the use of the yeast two-hybrid system, we have isolated genes encoding proteins that interact with a region of the amino-terminal proteolytic fragment of MSP-1 from the mouse parasite Plasmodium yoelii. This analysis has led to the isolation of two sequence-related molecules, one of which is the P. yoelii homologue of MSP-7 originally described in Plasmodium falciparum. BLAST analysis of the P. falciparum database has revealed that there are six related protein molecules present in this species encoded near each other on chromosome 13. In P. falciparum, we designated these molecules MSRP-1 to -5. Analysis of the P. yoelii database indicates a similar chromosomal organization for the two genes in the mouse parasite species. The three P. falciparum sequences with the highest degree of homology to the P. yoelii sequences isolated in the two-hybrid screen have been characterized at the molecular level (MSRP-1 to -3). Expression analysis indicated that the mRNAs are expressed at various levels in the different asexual stages. Immunofluorescence studies colocalized the expression of the MSRP molecules and the amino-terminal portion of MSP-1 to the surfaces of trophozoites. In vitro binding experiments confirmed the interaction between MSRP-1, MSRP-2, and the amino-terminal region of P. falciparum MSP-1.     

The Plasmodium falciparum RhopH2 promoter and first 24 amino acids are sufficient to target proteins to the rhoptries

The rhoptry secretory organelles of the malaria parasite, Plasmodium falciparum, contain a RhopH complex, which is composed of the proteins RhopH1, RhopH2, and RhopH3. RhopH1 is encoded by the rhoph1/clag multi-gene family, whereas RhopH2 and RhopH3 are encoded by single-copy genes. The precise function of the RhopH complex has not been identified, but it has been shown that the component proteins are involved in erythrocyte binding and perhaps participate in the formation of the parasitophorous vacuolar membrane. In this study, we have isolated pfrhoph2 promoter plus the signal peptide encoding sequence and generated transgene expression constructs to evaluate a trafficking and the RhopH complex formation in transgenic P. falciparum parasite lines. Interestingly, we found that the N-terminal 24 amino acids of RhopH2, including signal peptide sequence, were sufficient to target GFP to the rhoptries under the rhoph2 promoter. Because it was previously shown that the timing of the expression alone could not target proteins to the apical organelles, this targeting is likely mediated via a unique mechanism that is dependent on N-terminal 24 amino acids of RhopH2 early in the secretory pathway. The N-terminal one third of Clag3.1, which contains a distinct conserved domain with Toxoplasma gondii RON2, can not associate the RhopH complex as a GFP chimera, but a c-Myc-Clag3.1 chimera lacking the C-terminus successfully associates the RhopH complex indicating that cooperation of middle region is likely required but the C-terminus is not necessary.     

The Effect of Daily Co-Trimoxazole Prophylaxis on Natural Development of Antibody-Mediated Immunity against P. falciparum Malaria Infection in HIV-Exposed Uninfected Malawian Children

Background and Objectives

Co-trimoxazole prophylaxis, currently recommended in HIV-exposed, uninfected (HEU) children as protection against opportunistic infections, also has some anti-malarial efficacy. We determined whether daily co-trimoxazole prophylaxis affects the natural development of antibody-mediated immunity to blood-stage Plasmodium falciparum malaria infection.

Methods

Using an enzyme-linked immunosorbent assay, we measured antibodies to 8Plasmodium falciparum antigens (AMA-1, MSP-1₁₉, MSP-3, PfSE, EBA-175RII, GLURP R0, GLURP R2 and CSP) in serum samples from 33 HEU children and 31 HIV-unexposed, uninfected (HUU) children, collected at 6, 12 and 18 months of age.

Results

Compared to HIV-uninfected children, HEU children had significantly lower levels of specific IgG against AMA-1 at 6 months (p = 0.001), MSP-1₁₉ at 12 months (p = 0.041) and PfSE at 6 months (p = 0.038), 12 months (p = 0.0012) and 18 months (p = 0.0097). No differences in the IgG antibody responses against the rest of the antigens were observed between the two groups at all time points. The breadth of specificity of IgG response was reduced in HEU children compared to HUU children during the follow up period.

Conclusions

Co-trimoxazole prophylaxis seems to reduce IgG antibody responses to P. falciparum blood stage antigens, which could be as a result of a reduction in exposure of those children under this regime. Although antibody responses were regarded as markers of exposure in this study, further studies are required to establish whether these responses are correlated in any way to clinical immunity to malaria.     

Rapid Assessment of Malaria Transmission Using Age-Specific Sero-Conversion Rates

Background

Malaria transmission intensity is a crucial determinant of malarial disease burden and its measurement can help to define health priorities. Rapid, local estimates of transmission are required to focus resources better but current entomological and parasitological methods for estimating transmission intensity are limited in this respect. An alternative is determination of antimalarial antibody age-specific sero-prevalence to estimate sero-conversion rates (SCR), which have been shown to correlate with transmission intensity. This study evaluated SCR generated from samples collected from health facility attendees as a tool for a rapid assessment of malaria transmission intensity.

Methodology and Principal Findings

The study was conducted in north east Tanzania. Antibodies to Plasmodium falciparum merozoite antigens MSP-1₁₉ and AMA-1 were measured by indirect ELISA. Age-specific antibody prevalence was analysed using a catalytic conversion model based on maximum likelihood to generate SCR. A pilot study, conducted near Moshi, found SCRs for AMA-1 were highly comparable between samples collected from individuals in a conventional cross-sectional survey and those collected from attendees at a local health facility. For the main study, 3885 individuals attending village health facilities in Korogwe and Same districts were recruited. Both malaria parasite prevalence and sero-positivity were higher in Korogwe than in Same. MSP-1₁₉ and AMA-1 SCR rates for Korogwe villages ranged from 0.03 to 0.06 and 0.07 to 0.21 respectively. In Same district there was evidence of a recent reduction in transmission, with SCR among those born since 1998 [MSP-1₁₉ 0.002 to 0.008 and AMA-1 0.005 to 0.014 ] being 5 to 10 fold lower than among individuals born prior to 1998 [MSP-1₁₉ 0.02 to 0.04 and AMA-1 0.04 to 0.13]. Current health facility specific estimates of SCR showed good correlations with malaria incidence rates in infants in a contemporaneous clinical trial (MSP-1₁₉ r² = 0.78, p<0.01 & AMA-1 r² = 0.91, p<0.001).

Conclusions

SCRs generated from age-specific anti-malarial antibody prevalence data collected via health facility surveys were robust and credible. Analysis of SCR allowed detection of a recent drop in malaria transmission in line with recent data from other areas in the region. This health facility-based approach represents a potential tool for rapid assessment of recent trends in malaria transmission intensity, generating valuable data for local and national malaria control programs to target, monitor and evaluate their control strategies.