ArticleMalaria journal2021
Hyper-prevalence of submicroscopic Plasmodium falciparum infections in a rural area of western Kenya with declining malaria cases.
Article in Malaria journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 21 citations in OpenAlex.
- Impact of Insecticide-Treated Nets onTropical medicine and infectious disease · 2026Article
- Unmasking non-malarial mosquito-borne infections among febrile children in malaria-endemic regions of western Kenya.Scientific reports · 2026Article
- Article
- Reduction in Asymptomatic falciparum malaria infection amongst schoolchildren in three ecological zones of Ghana between 2017 and 2023.Scientific reports · 2025Article
- Regional variation in sulfadoxine-pyrimethamine resistance genotypes and haplotypes of Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase genes in Western Kenya.Malaria journal · 2025Article
- Gender-related factors affecting community malaria-related perceptions and practices in Migori County, Kenya.Malaria journal · 2025Article
- Prevalence of subpatent Plasmodium falciparum infections in regions with varying transmission intensities and implications for malaria elimination in Mainland Tanzania.Malaria journal · 2025Article
- Net ownership, utilization and malaria burden in the context of Piperonyl butoxide-LLINs intervention in western Kenya.PloS one · 2025Article
- Quality Control of Microscopic Diagnosis of Malaria in Healthcare Facilities and Submicroscopic Infections in Mossendjo, the Department of Niari, the Republic of the Congo.Pathogens (Basel, Switzerland) · 2024Article
- Haemoglobin thresholds to define anaemia from age 6 months to 65 years: estimates from international data sources.The Lancet. Haematology · 2024Article
- Clinical malaria incidence and health seeking pattern in geographically heterogeneous landscape of western Kenya.BMC infectious diseases · 2022Article
- Asymptomatic and submicroscopic Plasmodium infections in an area before and during integrated vector control in Homa Bay, western Kenya.Malaria journal · 2022Article
- Molecular characterization and genotype distribution of thioester-containing protein 1 gene in Anopheles gambiae mosquitoes in western Kenya.Malaria journal · 2022Article
- Malaria epidemic and transmission foci in highland of Kisii, western Kenya.Parasite epidemiology and control · 2022Article
- Risk associations of submicroscopic malaria infection in lakeshore, plateau and highland areas of Kisumu County in western Kenya.PloS one · 2022Article
- Rare Alleles and Signatures of Selection on the Immunodominant Domains of Pfs230 and Pfs48/45 in Malaria Parasites From Western Kenya.Frontiers in genetics · 2022Article
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16 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundThe gold standard for diagnosing Plasmodium falciparum infection is microscopic examination of Giemsa-stained peripheral blood smears. The effectiveness of this procedure for infection surveillance and malaria control may be limited by a relatively high parasitaemia detection threshold. Persons with microscopically undetectable infections may go untreated, contributing to ongoing transmission to mosquito vectors. The purpose of this study was to determine the magnitude and determinants of undiagnosed submicroscopic P. falciparum infections in a rural area of western Kenya.
methodsA health facility-based survey was conducted, and 367 patients seeking treatment for symptoms consistent with uncomplicated malaria in Homa Bay County were enrolled. The frequency of submicroscopic P. falciparum infection was measured by comparing the prevalence of infection based on light microscopic inspection of thick blood smears versus real-time polymerase chain reaction (RT-PCR) targeting P. falciparum 18S rRNA gene. Long-lasting insecticidal net (LLIN) use, participation in nocturnal outdoor activities, and gender were considered as potential determinants of submicroscopic infections.
resultsMicroscopic inspection of blood smears was positive for asexual P. falciparum parasites in 14.7% (54/367) of cases. All of these samples were confirmed by RT-PCR. 35.8% (112/313) of blood smear negative cases were positive by RT-PCR, i.e., submicroscopic infection, resulting in an overall prevalence by RT-PCR alone of 45.2% compared to 14.7% for blood smear alone. Females had a higher prevalence of submicroscopic infections (35.6% or 72 out of 202 individuals, 95% CI 28.9-42.3) compared to males (24.2%, 40 of 165 individuals, 95% CI 17.6-30.8). The risk of submicroscopic infections in LLIN users was about half that of non-LLIN users (OR = 0.59). There was no difference in the prevalence of submicroscopic infections of study participants who were active in nocturnal outdoor activities versus those who were not active (OR = 0.91). Patients who participated in nocturnal outdoor activities and use LLINs while indoors had a slightly higher risk of submicroscopic infection than those who did not use LLINs (OR = 1.48).
conclusionMicroscopic inspection of blood smears from persons with malaria symptoms for asexual stage P. falciparum should be supplemented by more sensitive diagnostic tests in order to reduce ongoing transmission of P. falciparum parasites to local mosquito vectors.
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