The role of submicroscopic parasitemia in malaria transmission: What is the evidence?

Jessica T. Lin*, David L. Saunders, Steven R. Meshnick

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

175 Scopus citations


Achieving malaria elimination requires targeting the human reservoir of infection, including those with asymptomatic infection. Smear-positive asymptomatic infections detectable by microscopy are an important reservoir because they often persist for months and harbor gametocytes, the parasite stage infectious to mosquitoes. However, many asymptomatic infections are submicroscopic and can only be detected by molecular methods. Although there is some evidence that individuals with submicroscopic malaria can infect mosquitoes, transmission is much less likely to occur at submicroscopic gametocyte levels. As malaria elimination programs pursue mass screening and treatment of asymptomatic individuals, further research should strive to define the degree to which submicroscopic malaria contributes to the infectious reservoir and, in turn, what diagnostic detection threshold is needed to effectively interrupt transmission.

Original languageEnglish
Pages (from-to)183-190
Number of pages8
JournalTrends in Parasitology
Issue number4
StatePublished - Apr 2014
Externally publishedYes


  • Asymptomatic infection
  • Diagnostic
  • Gametocyte
  • Malaria elimination
  • Reservoir


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