title: Asymptomatic malaria infections: detectability, transmissibility and public health relevance.
abstract: Most Plasmodium falciparum infections that are detected in community surveys are characterized by low-density parasitaemia and the absence of clinical symptoms. Molecular diagnostics have shown that this asymptomatic parasitic reservoir is more widespread than previously thought, even in low-endemic areas. In this Opinion article, we describe the detectability of asymptomatic malaria infections and the relevance of submicroscopic infections for parasite transmission to mosquitoes and for community interventions that aim at reducing transmission. We argue that wider deployment of molecular diagnostic tools is needed to provide adequate insight into the epidemiology of malaria and infection dynamics to aid elimination efforts.
authors.affiliation: 1] London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. [2] Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: Bousema
authors.affiliation: Imperial College, London, London SW7 2AZ, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Okell
authors.affiliation: Swiss Tropical Institute, 4051 Basel, Switzerland.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Felger
authors.affiliation: London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Drakeley
mesh_terms: D000818:Animals; D058345:Asymptomatic Infections; D009033:Culicidae / Q000469:parasitology*; D004197:Disease Reservoirs / Q000469:parasitology*; D005260:Female; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology*; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000469:parasitology / Q000517:prevention & control / Q000635:transmission; D008297:Male; D018512:Parasitemia; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011634:Public Health