Immunotechniques for epidemiology of malaria: appropriate tools for integration of primary health care with malaria research and control.

Community-based malaria control with integrated primary health care appears to be the most feasible approach for endemic countries in their struggle against malaria. To plan and implement personal protection and vector control measures, there is the need for comprehensive information about local modes of transmission. Experience with insecticide-based vector control programmes and entomological data accumulated over the years has revealed vector systems of extraordinary heterogeneity, creating multifaceted transmission situations. The primary health care-system offers an appropriate structure to collect and evaluate microepidemiological information countrywide. Community and health workers trained and supervised by qualified personnel could be involved in the assessment of clinical, parasitological and entomological indices. Community participation is facilitated if personnel are taught the use of immunotechniques. Tests can be performed on dried material which allows samples to be stored for months without refrigeration, so that transport to and processing in a central laboratory are not subject to time constraints. This paper describes and discusses enzyme-linked immunosorbent assays to determine if antibodies to sporozoites are present in blood collected as dried spots and to identify the origin of bloodmeals using dried mosquito abdomens.