Asymptomatic and low-density Plasmodium infections in India: an unexplored link

ABSTRACT

Presently in India, high endemic zones of malaria are shifting towards low endemic zones and in this changing scenario, tackling the asymptomatic and low-density infections (LDI) would be an important factor. Role of the asymptomatic and LDI in transmitting parasites successfully to mosquito vectors needs to be systematically investigated. We here highlight the limited work done on the burden of asymptomatic Plasmodium infections in India with an emphasis on its infectiousness, and infrastructure available for the detection of LDI. Studies reporting the threshold of gametocytes required for transmission of parasites are lacking for Indian malaria vectors. In the wake of malaria elimination target by 2030, specific point of care test is required to be developed for the detection of low density infections and/or asymptomatic patients. Also, mapping of asymptomatic malaria burden pan India and the role of LDI in vector infectivity would guide the way forward in achieving malaria elimination goal in India.

KEYWORDS:

• Asymptomatic malaria
• low density infection
• gametocyte density
• malaria elimination
• vector infectivity
• mass drug administration

Acknowledgments

We are thankful to Director, ICMR-National Institute of Malaria Research, Delhi for their support in writing this manuscript.

Author contributions

GK conceived the paper with input from JK. All authors participated in reviewing the literature, drafting the manuscript, and revising the manuscript for publication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.