title: Microscopic Plasmodium falciparum Gametocytemia and Infectivity to Mosquitoes in Cambodia.
abstract: Although gametocytes are essential for malaria transmission, in Africa many falciparum-infected persons without smear-detectable gametocytes still infect mosquitoes. To see whether the same is true in Southeast Asia, we determined the infectiousness of 119 falciparum-infected Cambodian adults to Anopheles dirus mosquitoes by membrane feeding. Just 5.9% of subjects infected mosquitoes. The 8.4% of patients with smear-detectable gametocytes were >20 times more likely to infect mosquitoes than those without and were the source of 96% of all mosquito infections. In low-transmission settings, targeting transmission-blocking interventions to those with microscopic gametocytemia may have an outsized effect on malaria control and elimination.
authors.affiliation: Division of Infectious Diseases, University of North Carolina School of Medicine.
authors.forename: Jessica T
authors.initials: JT
authors.lastname: Lin
authors.affiliation: Departments of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Ratawan
authors.initials: R
authors.lastname: Ubalee
authors.affiliation: Armed Forces Research Institute of Medical Sciences.
authors.forename: Chanthap
authors.initials: C
authors.lastname: Lon
authors.affiliation: Division of Infectious Diseases, University of North Carolina School of Medicine.
authors.forename: Sujata
authors.initials: S
authors.lastname: Balasubramanian
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Worachet
authors.initials: W
authors.lastname: Kuntawunginn
authors.affiliation: Division of Infectious Diseases, University of North Carolina School of Medicine.
authors.forename: Rifat
authors.initials: R
authors.lastname: Rahman
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Piyaporn
authors.initials: P
authors.lastname: Saingam
authors.affiliation: National Malaria Center, Phnom Penh.
authors.forename: Thay Kheang
authors.initials: TK
authors.lastname: Heng
authors.affiliation: Royal Cambodian Armed Forces, Phnom Penh.
authors.forename: Dav
authors.initials: D
authors.lastname: Vy
authors.affiliation: Battambang Referral Hospital, Cambodia.
authors.forename: Savoeun
authors.initials: S
authors.lastname: San
authors.affiliation: Armed Forces Research Institute of Medical Sciences.
authors.forename: Sarath
authors.initials: S
authors.lastname: Nuom
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Hana
authors.initials: H
authors.lastname: Burkly
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Nitima
authors.initials: N
authors.lastname: Chanarat
authors.affiliation: Departments of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Chanudom
authors.initials: C
authors.lastname: Ponsa
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health.
authors.forename: Lauren
authors.initials: L
authors.lastname: Levitz
authors.affiliation: Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill.
authors.forename: Christian
authors.initials: C
authors.lastname: Parobek
authors.affiliation: National Malaria Center, Phnom Penh.
authors.forename: Char Meng
authors.initials: CM
authors.lastname: Chuor
authors.affiliation: Royal Cambodian Armed Forces, Phnom Penh.
authors.forename: Sok
authors.initials: S
authors.lastname: Somethy
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Michele
authors.initials: M
authors.lastname: Spring
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Lanteri
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: Panita
authors.initials: P
authors.lastname: Gosi
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Meshnick
authors.affiliation: Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: David L
authors.initials: DL
authors.lastname: Saunders
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000852:Anopheles / Q000469:parasitology*; D005260:Female; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology*; D016778:Malaria, Falciparum / Q000469:parasitology* / Q000635:transmission*; D008875:Middle Aged; D059208:Parasite Load; D018512:Parasitemia / Q000469:parasitology* / Q000635:transmission*; D010963:Plasmodium falciparum / Q000472:pathogenicity*; D055815:Young Adult
keywords: Anopheles dirus; Plasmodium falciparum; gametocyte; infectious reservoir; malaria transmission; membrane feeding; submicroscopic