Asymptomatic School-Aged Children Are Important Drivers of Malaria Transmission in a High Endemicity Setting in Uganda.

Rek, J; Blanken, SL; Okoth, J; Ayo, D; Onyige, I; Musasizi, E; Ramjith, J; Andolina, C; Lanke, K; Arinaitwe, E; +8 more...Olwoch, P; Collins, KA; Kamya, MR; Dorsey, G; Drakeley, CORCID logo; Staedke, SGORCID logo; Bousema, TORCID logo; Conrad, MD and (2022) Asymptomatic School-Aged Children Are Important Drivers of Malaria Transmission in a High Endemicity Setting in Uganda. The Journal of infectious diseases, 226 (4). pp. 708-713. ISSN 0022-1899 DOI: 10.1093/infdis/jiac169
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Achieving malaria elimination requires a better understanding of the transmissibility of human infections in different transmission settings. This study aimed to characterize the human infectious reservoir in a high endemicity setting in eastern Uganda, using gametocyte quantification and mosquito feeding assays. In asymptomatic infections, gametocyte densities were positively associated with the proportion of infected mosquitoes (β = 1.60; 95% CI, 1.32-1.92; P < .0001). Combining transmissibility and abundance in the population, symptomatic and asymptomatic infections were estimated to contribute to 5.3% and 94.7% of the infectious reservoir, respectively. School-aged children (5-15 years old) contributed to 50.4% of transmission events and were important drivers of malaria transmission.


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