Antimalarial transmission-blocking vaccines

Aspects of the current status of development of antimalarial, transmission-blocking (TB) vaccines are reviewed in relation to the biology of malaria transmission and the potential impact of such vaccines in endemic populations. It is proposed that the impact of TB vaccines upon populations will be no less than that of the successful and widely implemented strategies of impregnated bednets and insecticidal sprays. Additionally, it is suggested that the observed lack of polymorphism in many TB target antigens should promote their adoption, in combination with other vaccine components targeted at more polymorphic, asexual-stage antigens, in a polyvalent vaccine or in combination with chemotherapy campaigns. It is recommended that TB vaccines should be considered not only for vaccination of those in endemic countries but also for travellers, to reduce the possibility of malaria being exported from endemic countries to the expanding number of nations in which malaria could be transmitted by local vectors.