Multiplex bead assays enable integrated serological surveillance and reveal cross-pathogen vulnerabilities in Zambezia Province, Mozambique

Andrea C. Carcelen (), Celso Monjane, Sophie Bérubé, Saki Takahashi, Thebora Sultane, Imelda Chelene, Gretchen Cooley, E. Brook Goodhew, Catriona Patterson, Kevin Tetteh, Manuel Mutambe, Melissa M. Higdon, George Mwinnyaa, Gilberto Nhapure, Pedro Duce, Diana L. Martin, Christopher Drakeley, William J. Moss and Ivalda Macicame
Additional contact information
Andrea C. Carcelen: Johns Hopkins Bloomberg School of Public Health
Celso Monjane: Instituto Nacional de Saúde
Sophie Bérubé: The University of Florida
Saki Takahashi: Johns Hopkins Bloomberg School of Public Health
Thebora Sultane: Instituto Nacional de Saúde
Imelda Chelene: Instituto Nacional de Saúde
Gretchen Cooley: Centers for Disease Control and Prevention
E. Brook Goodhew: Centers for Disease Control and Prevention
Catriona Patterson: London School of Hygiene and Tropical Medicine
Kevin Tetteh: London School of Hygiene and Tropical Medicine
Manuel Mutambe: Instituto Nacional de Saúde
Melissa M. Higdon: Johns Hopkins Bloomberg School of Public Health
George Mwinnyaa: Johns Hopkins Bloomberg School of Public Health
Gilberto Nhapure: Instituto Nacional de Estatística
Pedro Duce: Instituto Nacional de Estatística
Diana L. Martin: Centers for Disease Control and Prevention
Christopher Drakeley: London School of Hygiene and Tropical Medicine
William J. Moss: Johns Hopkins Bloomberg School of Public Health
Ivalda Macicame: Instituto Nacional de Saúde

Nature Communications, 2025, vol. 16, issue 1, 1-17

Abstract: Abstract Multiplex serological assays simultaneously measure antibodies to multiple antigens, furnishing insights into exposure and susceptibility to several pathogens and cross-pathogen vulnerabilities. Our serosurvey tests dried blood spots from 1292 individuals for IgG antibodies to 35 antigens from 18 pathogens using a multiplex bead assay for vaccine preventable diseases, malaria, SARS-CoV-2, neglected tropical diseases, and enteric pathogens in Mozambique. We produce pathogen-specific seroprevalence estimates and age-seroprevalence curves and identify spatial differences in seroprevalence. Rural clusters have higher odds of seropositivity to most NTDs neglected tropical diseases, Plasmodium falciparum malaria, and enteric pathogens, but lower odds of seropositivity to SARS-CoV-2 and vaccine preventable diseases compared to urban clusters. This co-occurrence identifies clusters with high vulnerability to multiple pathogens. We identify a candidate group of antigens that are correlated with high overall vulnerability. Our results demonstrate a role for multiplex serology in integrated disease surveillance to guide control strategies for individual and co-endemic pathogens.

Date: 2025
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DOI: 10.1038/s41467-025-62305-9

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