Cited by 386Malaria Research and ControlHemoglobinopathies and Related DisordersBird parasitology and diseases

“Asymptomatic” Malaria: A Chronic and Debilitating Infection That Should Be Treated

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Chen, Ingrid, Clarke, Siân E., Gosling, Roly, Hamainza, Busiku, Killeen, Gerry, Magill, Alan, O’Meara, Wendy, Price, Ric N. +1 more·2016·PLOS Medicine

Abstract

Points• Are afebrile malaria infections truly asymptomatic, benign, or even beneficial to the individual?The evidence suggests the contrary.• So-called "asymptomatic" malaria infections are associated with recurrent episodes of symptomatic parasitemia, chronic anemia, maternal and neonatal mortality, co-infection with invasive bacterial disease, cognitive impairment, and ongoing transmission of the parasite.• "Asymptomatic" malaria infections have significant health and societal consequences, and we propose that they should be renamed "chronic" malaria infections.• Targeting chronic malaria infections poses major scientific, operational, and ethical challenges.• We call for the malaria community to work with malaria control and elimination programs to target all malaria infections, irrespective of their density or presentation.The operational challenges to detect and treat chronic infections are significant, but accomplishing this is likely to result in substantial gains to both the individual and society.

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  • Submicroscopic cases are not detected or treated, resulting in severe outcomes for the mother and child (anemia and severe malaria) while also perpetuating parasite transmission and disease endemicity.

    “submicroscopic cases are not detected or treated, resulting in severe outcomes for the mother and child (anemia and severe malaria) while also perpetuating parasite transmission and disease endemicity [20,23,24,25,26]”

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Authors
Chen, I., Clarke, S. E., Gosling, R., Hamainza, B., Killeen, G., Magill, A., O’Meara, W., Price, R. N., & Riley, E. M.
Affiliations
  • University of California, San Francisco (US)
  • London School of Hygiene & Tropical Medicine (GB)
  • Ministry of Health (ZM)
  • Ifakara Health Institute (TZ)
  • Gates Foundation (US)
  • Duke University (US)
  • Charles Darwin University (AU)
Corresponding author
Gosling, Roly
Venue
PLOS Medicine
Published
2016-01-19
Volume
13
Issue
1
Pages
e1001942
ISSN
  • 1549-1277 (ISSN-L)
  • 1549-1676
OpenAlex
W2266475816
Cited by
386
References
66
Citations by year
2026: 20 · 2025: 31 · 2024: 41 · 2023: 41 · 2022: 36 · 2021: 59 · 2020: 39 · 2019: 39 · 2018: 34 · 2017: 32 · 2016: 14
FWCI
5.86
Type
journal article
Language
en
Open access
Locations
  • PLoS Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSTM Online Archive (Liverpool School of Tropical Medicine) (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Bill and Melinda Gates Foundation (A115501, A122394)
  • Wellcome Trust (FP7/2007–2013, 084933, 091625)
  • European Commission (242095)
  • Department for International Development
  • Duke Global Health Institute, Duke University
  • Medical Research Council (G1000808)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
  • Life Sciences › Immunology and Microbiology › Parasitology › Bird parasitology and diseases
Keywords
asymptomatic malaria, chronic malaria infection, chronic anemia, maternal and neonatal mortality, cognitive impairment, malaria transmission, malaria elimination, parasite density
MeSH terms
Anemia, Chronic Disease, Cognition Disorders, Humans, Malaria, Treatment Outcome, Asymptomatic Diseases

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