Evidence map›Paper›PMID 42155491›Full record

Observational studyThe Lancet. Microbe2026

Assessing the effect of parasite antigen genetic diversity on performance of Plasmodium vivax serological exposure markers for malaria: a multicentre observational diagnostic accuracy study.

Alison Paolo N Bareng, Kenneth W Wu, Eizo Takashima, Dionne C Argyropoulos, Lauren Smith, Myo T Naung, Ramin Mazhari, Kael Schoffer, Nicholas Kiernan-Walker, Anju Abraham and 13 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Lancet. Microbe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Alison Paolo N BarengCentre for Innovation in Infectious Diseases and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation and School of Medicine, Deakin University, Geelong, VIC, Australia.
Kenneth W WuWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.
Eizo TakashimaDivision of Malaria Research, Proteo-Science Center, Ehime University, Matsuyama, Ehime, Japan.
Dionne C ArgyropoulosWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
Lauren SmithWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.
Myo T NaungCentre for Innovation in Infectious Diseases and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation and School of Medicine, Deakin University, Geelong, VIC, Australia.
Ramin MazhariWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.
Kael SchofferWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
Nicholas Kiernan-WalkerWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
Anju AbrahamWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
Macie LamontWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
Somya MehraLife Sciences Discipline, Burnet Institute, Melbourne, VIC, Australia.
Pailene S LimWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.
Jetsumon SattabongkotMahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Wuelton MonteiroFundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil.
Marcus LacerdaFundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil.
Julie HealerWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
Chetan E ChitnisUnité de Biologie de Plasmodium et Vaccins, Institut Pasteur, Université Paris Cité, Paris, France.
Wai-Hong ThamWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia; Research School of Biology, Australian National University, Canberra, ACT, Australia.
Takafumi TsuboiDivision of Cell-Free Sciences, Proteo-Science Center, Ehime University, Matsuyama, Ehime, Japan.
Ivo MuellerWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia; School of Global Health, Shanghai Jiao Tong University, Shanghai, China.
Alyssa E BarryCentre for Innovation in Infectious Diseases and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation and School of Medicine, Deakin University, Geelong, VIC, Australia; Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia; Life Sciences Discipline, Burnet Institute, Melbourne, VIC, Australia.
Rhea J LongleyWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia; Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. Electronic address: Longley.r@wehi.edu.au.

Funding

Discovery & validation of novel P. vivax antigens for identification and monitoriR01AI104822 · NIAID · MAHIDOL UNIVERSITY · PI PRACHUMSRI, JETSUMON · 2013 to 2017
$672k
NIAID NIH HHS R01 AI104822
6 · The paper itself

Abstract

backgroundPlasmodium vivax poses a major obstacle to malaria elimination because this parasite can lie dormant in the liver for weeks to months before reactivating and causing a relapse of infection. These dormant forms (hypnozoites) cannot be detected using standard diagnostics, but P vivax exposure in the previous 9 months and, by proxy, hypnozoite carriage, can be inferred using serological markers. In this study, we aimed to examine how genetic variation in P vivax affects the utility of these markers and whether redesigned antigens could improve performance.

methodsIn this observational diagnostic accuracy study, we analysed global P vivax genetic data to assess variation in leading serological markers (n=14). Accordingly, we expressed new haplotypes that better reflect global sequence diversity for eight antigens, compared with the commonly used reference strain (Sal-1). Antibody responses against these were tested using samples from cohorts in Brazil and Thailand, with magnitude assessed in relation to how recently participants had a qPCR-detectable blood-stage P vivax infection. We compared the ability of the haplotypes versus the reference to correctly identify individuals infected within the previous 9 months.

findingsExtensive global genetic diversity was identified in two P vivax antigens, MSP5 (π=14·8 × 10

interpretationEven highly diverse antigens can be effective serological markers. Our findings highlight the importance of testing the effect of genetic diversity and suggest practical strategies to ensure consistent performance across regions.

fundingAustralian National Health and Medical Research Council.

Indexed as

Antigens, ProtozoanGenetic VariationMalaria, VivaxPlasmodium vivaxAntibodies, ProtozoanBiomarkersBrazilFemaleHaplotypesHumansThailandAntibodies, ProtozoanAntigens, ProtozoanBiomarkers

Identifiers

PMID42155491
PMCPMC13345667

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.