Dry season prevalence of Plasmodium falciparum in asymptomatic Gambian children, with a comparative evaluation of diagnostic methods (original) (raw)

Background Subclinical infection with Plasmodium falciparum remains highly prevalent, yet diagnosing these often low density infections remains a challenge. Infections can be subpatent, falling below the limit of detection for conventional thick-film microscopy and rapid diagnostic testing (RDT). In this study, we characterised the prevalence of subclinical P. falciparum infections in school-aged children at the start of the dry season in the Upper River Region of The Gambia in 2017/2018, with a goal to also compare the utility of different diagnostic tools. Methods In a cross-sectional survey of children living in 29 villages on the south bank of the Gambia river (median age of 10 years), matched microscopy, RDT (detecting histidine-rich protein II) and polymerase chain reaction (targeting either 18S rRNA or var gene acidic terminal sequence and (varATS)) were used to determine the prevalence of patent and subpatent infections and to compare the performance of the different diagnos...