SynthesisThe Lancet. Microbe2021
Global patterns of submicroscopic
Synthesis in The Lancet. Microbe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Prevalence and determinants of asymptomatic malaria infection among schoolchildren in Africa: insights from a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Prevalence of and risk factors for microscopic and submicroscopic malaria infections in pregnancy: a systematic review and meta-analysis.The Lancet. Global health · 2023Pooled it
- The Impact of Emerging Plasmodium knowlesi on Accurate Diagnosis by Light Microscopy: A Systematic Review and Modeling Analysis.The American journal of tropical medicine and hygiene · 2023Pooled it
- A sustainable house design to improve child health in rural Africa: a cluster-randomized controlled trial.Nature medicine · 2026Trial
- Detection ofASM case reports · 2026Article
- Article
- Comparative evaluation of multiplex bead assay, polymerase chain reaction, and rapid diagnostic test for P. falciparum detection in community surveys in Malawi.Malaria journal · 2026Article
- Plasmodium falciparum infections and number needed to screen among refugees arriving from sub-Saharan Africa.Journal of travel medicine · 2026Article
- Hidden burden of malaria in pregnancy in hard-to-reach areas of Odisha, India: challenges to elimination and the case for integrating molecular surveillance.Frontiers in public health · 2026Article
- Hidden burden: submicroscopic Plasmodium spp. infections in indigenous populations of the Peruvian Amazon.Malaria journal · 2025Article
- Assessing the impact of temporal changes in transmission on Plasmodium falciparum strains in Asembo, western Kenya (1996-2017) using within-host metrics via 24-SNP barcodes.Malaria journal · 2025Article
- Molecular investigation ofBMJ global health · 2025Article
- Sociodemographic and ecological factors associated with malaria and malaria recurrence risk in children in Msambweni, Kwale County, Kenya.Malaria journal · 2025Article
- Prevalence of submicroscopic congenital malaria and associated risk factors in an area of low endemicity of Guatemala.Malaria journal · 2025Article
- Enhanced blood parasite species identification using V4-V9 18S rDNA barcoding by universal primers on a nanopore platform.Scientific reports · 2025Article
- Mining and malaria in the Brazilian Amazon and in the Yanomami indigenous land.PLoS neglected tropical diseases · 2025Article
- Antibody responses to gSG6-p1, AgSAP, and SAMSP1 following anopheline salivary exposure.Parasites & vectors · 2025Article
- Sensitive near point-of-care detection of asymptomatic and submicroscopic Plasmodium falciparum infections in African endemic countries.Nature communications · 2025Article
- Efficacy of Focal Primaquine Mass Administration for EliminatingOpen forum infectious diseases · 2025Article
- Malaria and anaemia prevalence and associated factors among pregnant women initiating antenatal care in two regions in Ghana: an analytical cross-sectional study.BMC pregnancy and childbirth · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundAdoption of molecular techniques to detect
methodsIn this systematic review and meta-analysis we searched PubMed and Web of Science from Jan 1, 2010, until Oct 11, 2020, for cross-sectional studies reporting data on asexual
findingsOf 4893 identified studies, we retained 121 after screening and removal of duplicates. 45 studies from a previous systematic review were included giving 166 studies containing 551 cross-sectional survey microscopy and PCR prevalence pairs. Our results show that submicroscopic infections predominate in low-transmission settings across all regions, but also reveal marked geographical variation, with the proportion of infections that are submicroscopic being highest in South American surveys and lowest in west African surveys. Although current transmission levels partly explain these results, we find that historical transmission intensity also represents a crucial determinant of the size of the submicroscopic reservoir, as does the demographic structure of the infected population (with submicroscopic infection more likely to occur in adults than in children) and the PCR or microscopy methodology used. We also observed a small yet significant influence of seasonality, with fewer submicroscopic infections observed in the wet season than the dry season. Integrating these results with estimates of infectivity in relation to parasite density suggests the contribution of submicroscopic infections to transmission across different settings is likely to be highly variable.
interpretationSignificant variation in the prevalence of submicroscopic infection exists even across settings characterised by similar current levels of transmission. These differences in submicroscopic epidemiology potentially warrant different approaches to targeting this infected subgroup across different settings to eliminate malaria.
fundingBill & Melinda Gates Foundation, The Royal Society, and the UK Medical Research Council.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.