Advances and Challenges in Transmission-Blocking Malaria Vaccine Development. A Systematic Review

Malaria continues to cause enormous human suffering throughout most of the tropics and subtropics. In sub-Saharan Africa alone, it is estimated that about two million children die each year due to malaria. Vector control and malaria chemotherapy strategies that were previously effective in controlling and treating malaria, respectively, are now largely ineffective owing to the spread of insecticide-resistant mosquitoes and drug-resistant parasites. A vaccine targeting the sexual stages of the parasite and block transmission is needed to reinforce current malaria control and eradication efforts. Here, we review the status of malaria transmission-blocking vaccines. We focused on the efficacy, progress and development challenges of transmission-blocking vaccines. Pfs25 and Pfs48/45 are essentially the lead-candidates malaria transmission-blocking vaccine and should be studied further in clinical trials. Our review highlights the need to develop novel malaria elimination interventions, particularly an effective malaria vaccine with transmission-blocking activity.