title: Sub-microscopic gametocyte carriage in febrile children living in different areas of Gabon.
abstract: BACKGROUND
  Considering malaria prevalence declines in parts of sub-Saharan Africa, such as Gabon, identification of the human infectious reservoir is important for successful malaria control. Microscopic and sub-microscopic parasites contribute to malaria transmission. The aim of the present study was to evaluate the proportion of microscopic and sub-microscopic gametocyte carriers among febrile patients in two different areas of Gabon.
  
  
  METHODS
  Samples from febrile children aged less than 11 years old were collected from February 2008 to January 2009 at two health centres of Gabon. Patients were screened for the presence of asexual Plasmodium falciparum parasites. Gametocyte carriage was determined by microscopy and QT-NASBA.
  
  
  RESULTS
  Gametocytes were detected in 5.3% (n = 16/304) of children by microscopy compared to 45.7% (n = 139/304) by QT-Nasba. Sub-microscopic gametocyte carriage (ie microscopy negative and QT-Nasba positive) was found in 89.2% (n = 124/139) of patients. Among patients with microscopically detected trophozoites, the proportion of sub-microscopic gametocyte (SMG) carriers was 58.4% (n = 118/202) and 6% in samples from children with negative slides (p < 0.01). In Oyem, where malaria prevalence is three-fold higher than in Owendo, SMG carriage was more frequent (49.0% vs 32.6% in Owendo; p < 0.01).
  
  
  CONCLUSIONS
  Sub-microscopic gametocytaemia is common among Gabonese febrile children. They might strongly contribute to maintain malaria transmission. However, further analysis of sub-microscopic parasite carriage among asymptomatic individuals will be helpful to better characterize malaria transmission.
authors.affiliation: Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon. dpmawili@hotmail.com.
authors.forename: Denise Patricia
authors.initials: DP
authors.lastname: Mawili-Mboumba
authors.forename: Rosalie
authors.initials: R
authors.lastname: Nikiéma
authors.forename: Marielle Karine
authors.initials: MK
authors.lastname: Bouyou-Akotet
authors.forename: Noemi
authors.initials: N
authors.lastname: Bahamontes-Rosa
authors.forename: Alfred
authors.initials: A
authors.lastname: Traoré
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Kombila
mesh_terms: D002353:Carrier State / Q000453:epidemiology* / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008853:Microscopy; D021141:Nucleic Acid Amplification Techniques; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D015995:Prevalence