ArticleMalaria journal2018
Subpatent malaria in a low transmission African setting: a cross-sectional study using rapid diagnostic testing (RDT) and loop-mediated isothermal amplification (LAMP) from Zambezi region, Namibia.
Article in Malaria journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 31 citations in OpenAlex.
- Targeting malaria in high-risk populations in low endemic regions in northern Namibia: a quasi-experimental controlled trial to reduce malaria in seasonal agricultural workers and cattle herders.BMJ global health · 2025Trial
- Extension of efficacy range for targeted malaria-elimination interventions due to spillover effects.Nature medicine · 2024Trial
- Effectiveness of reactive focal mass drug administration and reactive focal vector control to reduce malaria transmission in the low malaria-endemic setting of Namibia: a cluster-randomised controlled, open-label, two-by-two factorial design trial.Lancet (London, England) · 2020Trial
- Evaluation ofiScience · 2025Article
- The burden and diagnostic challenges of subclinical Plasmodium falciparum infections in Southern Ghana.BMC infectious diseases · 2025Article
- Prevalence of subpatent Plasmodium falciparum infections in regions with varying transmission intensities and implications for malaria elimination in Mainland Tanzania.Malaria journal · 2025Article
- Prevalence of asymptomatic malaria infection and associated risk factors in Mizan-Aman town, Ethiopia: community-based cross-sectional study.Malaria journal · 2025Article
- Bridging the Gap from Molecular Surveillance to Programmatic Decisions for Malaria Control and Elimination.The American journal of tropical medicine and hygiene · 2025Review
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- Malaria diagnosis using a combined system of a simple and fast extraction method with a lyophilised Dual-LAMP assay in a non-endemic setting.Pathogens and global health · 2024Article
- The question of the early diagnosis of asymptomatic and subpatent malaria in pregnancy: Implications for diagnostic tools in a malaria endemic area.European journal of obstetrics & gynecology and reproductive biology: X · 2023Article
- Health care provider practices in diagnosis and treatment of malaria in rural communities in Kisumu County, Kenya.Malaria journal · 2022Article
- The global burden of Plasmodium vivax malaria is obscure and insidious.PLoS medicine · 2021Article
- Population size estimation of seasonal forest-going populations in southern Lao PDR.Scientific reports · 2021Article
- Malaria Rapid Diagnostic Tests: Literary Review and Recommendation for a Quality Assurance, Quality Control Algorithm.Diagnostics (Basel, Switzerland) · 2021Review
- Risk factors for anaemia among Ghanaian women and children vary by population group and climate zone.Maternal & child nutrition · 2021Article
- Community acceptance of reactive focal mass drug administration and reactive focal vector control using indoor residual spraying, a mixed-methods study in Zambezi region, Namibia.Malaria journal · 2021Article
- Performance and Application of Commercially Available Loop-Mediated Isothermal Amplification (LAMP) Kits in Malaria Endemic and Non-Endemic Settings.Diagnostics (Basel, Switzerland) · 2021Review
- Malaria risk factors in northern Namibia: The importance of occupation, age and mobility in characterizing high-risk populations.PloS one · 2021Article
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Authors and funding
18 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundSubpatent malaria infections, or low-density infections below the detection threshold of microscopy or standard rapid diagnostic testing (RDT), can perpetuate persistent transmission and, therefore, may be a barrier for countries like Namibia that are pursuing malaria elimination. This potential burden in Namibia has not been well characterized.
methodsUsing a two-stage cluster sampling, cross-sectional design, subjects of all age were enrolled during the end of the 2015 malaria transmission season in Zambezi region, located in northeast Namibia. Malaria RDTs were performed with subsequent gold standard testing by loop-mediated isothermal amplification (LAMP) using dried blood spots. Infection prevalence was measured and the diagnostic accuracy of RDT calculated. Relationships between recent fever, demographics, epidemiological factors, and infection were assessed.
resultsPrevalence of Plasmodium falciparum malaria infection was low: 0.8% (16/1919) by RDT and 2.2% (43/1919) by LAMP. All but one LAMP-positive infection was RDT-negative. Using LAMP as gold standard, the sensitivity and specificity of RDT were 2.3% and 99.2%, respectively. Compared to LAMP-negative infections, a higher portion LAMP-positive infections were associated with fever (45.2% vs. 30.4%, p = 0.04), though 55% of infections were not associated with fever. Agricultural occupations and cattle herding were significantly associated with LAMP-detectable infection (Adjusted ORs 5.02, 95% CI 1.77-14.23, and 11.82, 95% CI 1.06-131.81, respectively), while gender, travel, bed net use, and indoor residual spray coverage were not.
conclusionsThis study presents results from the first large-scale malaria cross-sectional survey from Namibia using molecular testing to characterize subpatent infections. Findings suggest that fever history and standard RDTs are not useful to address this burden. Achievement of malaria elimination may require active case detection using more sensitive point-of-care diagnostics or presumptive treatment and targeted to high-risk groups.
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