Addressing low-density malaria infections in India and other endemic part of the world—the opportune time?

Abstract

Shifting from high- to low-malaria transmission accompanies a higher proportion of asymptomatic low-density malaria infections (LDMI). Currently, several endemic countries, such as India, are experiencing this shift as it is striving to eliminate malaria. LDMI is a complex concept for which there are several important questions yet unanswered on its natural history, infectiousness, epidemiology, and pathological and clinical impact. India is on the right path to eliminating malaria, but it is facing the LDMI problem. A brief discussion on the concept and definitions of LDMI is beforehand presented. Also, an exhaustive review and critical analysis of the existing literature on LDMI in malaria-endemic areas, including India, are included in this review. Finally, we opine that addressing LDMI in India is ethically and pragmatically achievable, and a pool of sine qua non conditions is required to efficiently and sustainably eliminate malaria.

Keywords:

• Malaria
• low-density infections
• elimination
• challenges
• India

Acknowledgments

First author Dr LPKF would like to thank The World Academy of Sciences (TWAS), Trieste, Italy for his fellowship award (DBT-TWAS Postgraduate Fellowship 2017). The authors also thank ICMR-NIMR for infrastructure support towards providing a working environment. Comments and suggestions from anonymous reviewers had immensely helped in improving the manuscript to a significant extent 

Author contributions

LPKF: Conceptualization, Methodology, Software, Visualization, Validation, Formal analysis, Investigation, Data curation, Writing – Original draft, Writing – Review and Editing.

AM: Methodology, Visualization, Validation, Formal analysis, Investigation, Data curation, Writing – Original draft, Writing – Review and Editing.

VS: Conceptualization, Methodology, Visualization, Validation, Formal analysis, Investigation, Data curation, Writing – Original draft, Critical review and final editing, Project administration, Supervision.

All authors edited and approved the final manuscript and had access to the raw data. LPKF, AM and VS accessed and verified all data and had final responsibility to submit for publication.

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and supplemental materials.

Additional information

Funding

This study received no financial support.