As malaria declines, an increasing proportion of the parasites exist in asymptomatic patients. Furthermore, parasites can exist in the peripheral blood at very low levels, undetectable by conventional microscopy. These parasite populations provide an important reservoir which maintains malaria transmission, particularly in the final stages of elimination or when control efforts are predominantly passive (that is, waiting for symptomatic patients to present to clinics with disease). ACREME is developing novel strategies to undertake cross-sectional surveys, screen large populations and identify areas where low level and infrequent infections are occurring. These include testing blood samples for antibodies to malaria suggestive of recent exposure, as well as operational research into emerging tools for high-sensitivity detection of parasite infection (for example high sensitivity RDT and isothermal amplification).
Other project team members: Vashti Irani, Damien Drew, Kamala Thriemer, Benedikt Ley, Michelle Boyle