Vol. 13 No. 94-111 (2022): The role of asymptomatic malaria infection in the epidemiology and control of Malaria

Despite the recent progress made in the control and eradication of malaria, the disease remains the first endemic especially in sub-Saharan Africa. Malaria often results in a series of clinical presentations, from severe to uncomplicated or mild, and in poorly understood asymptomatic infections. The progress of malaria control interventions has been hindered by the presence of asymptomatic carriage of malaria parasites, its mis-diagnosis, and especially false negative results. This phenomenon has been poorly attributed to the recent mass usage of the substandard Rapid Diagnosis Tests (RDTs) and on the other hand, the global malaria eradication program has focused on symptomatic malaria. Consequently, asymptomatic infection remains undetected and provides a silent natural reservoir that sustains transmission of Plasmodium species in the community. Experts have identified the possible intricacies between host, parasites, age, co-infection and/or environmental factors among others to the complexity of asymptomatic infection. Therefore, in order to achieve the recent World Health Organization developed Strategic Framework for malaria elimination from 2016 to 2030 to reduce malaria morbidity and mortality by 90% and eliminate malaria in 35 countries by 2030, it is critical to interrupt the ongoing malaria transmission from the asymptomatic reservoir. Evidence from these studies suggests the strict inclusion of asymptomatic patients in malaria intervention and the adoption of ultrasensitive diagnostics in malaria surveillance and treatment.