Project information
A large proportion of malaria infections are asymptomatic meaning that those infected do not seek treatment. However, these individuals remain infectious to mosquitoes and hence continue to sustain transmission. A proportion of these infections are “sub-patent” – that is, low-density infections that are not detectable using standard diagnostics: light microscopy or current rapid diagnostic tests.
Our work focuses on combining prevalence and infectivity datasets from multiple transmission settings to characterise the "infectious reservoir" using insights from transmission dynamics models to understand the relative role of different individuals in sustaining transmission. We have characterised the proportion of infections which are sub-patent across different transmission settings, age groups and during pregnancy. In particular, we are interested in how this reservoir shifts as transmission declines and the implications of this shift for malaria elimination.
Selected publications
Whittaker C, Slater HC, Bousema T, Drakeley CJ, Ghani AC, Okell LC. Global Patterns of Submicroscopic Plasmodium falciparum Malaria Infection: Insights from A Systematic Review and Meta-Analysis of Population Surveys. Lancet Microbe 2021
Walker P, Cairns M, Slater H, Gutman J, Kayentao K, Williams J, Coulibaly S, Khairallah C, Taylor S, Meshnick S, Hill J, Mwapasa V, Kalilani-Phiri L, Bojang K, Kariuki S, Tagbor H, Griffin J, Madanitsa M, Ghani A, Desai M, ter Kuile Fet al., 2020, Modelling the incremental benefit of introducing malaria screening strategies to antenatal care in Africa, Nature Communications, Vol: 11, Pages: 1-12, ISSN: 2041-1723
Slater HC, Ross A, Felger I, Hofmann NE, Robinson L, Cook J, Goncalves B, Björkman A, Morris U, Msellem M, Ouedraogo AL, Koepfli C, Mueller I, Tadesse F, Gad. isa E, Das S, Domingo G, Kapulu M, Midega J, Owusu-Agyei S, Nabet C, Doumbo O, Piarroux R, Koram K, Lucchi N, Udhayakumar V, Mosha J, Tiono A, Chandramohan D, Gosling R, Mwingira F, Sauerwein R, Riley E, Paul R, White NJ, Nosten F, Imwong M, Bousema T, Drakeley C, Okell LC The density, temporal dynamics and infectiousness of subpatent P. falciparum infections. Nat Comms 2019.
Wu L, van de Hoogen L, Bousema T, Slater H, Ghani AC, Drakeley C, Okell L (2015). Detecting asymptomatic Plasmodium falciparum infections to inform control and elimination strategies – how do current diagnostics compare? Nature 528 S86-93.
Bousema T, Okell L, Felger I, Drakeley C (2014). Asymptomatic malaria infections: detectability, transmissibility and public health relevance. Nat Rev Microbiol 12 833-40.
Okell LC, Bousema T, Griffin JT, Ouedraogo AL, Ghani AC, Drakeley CJ (2012). Factors determining the occurrence of submicroscopic malaria infections and their relevance for control. Nature Communications 3 1237.
J. D. Challenger, D. Olivera Mesa, D. F. Da, R. S. Yerbanga, T. Lefèvre, A. Cohuet and T. S. Churcher: Predicting the public health impact of a malaria transmission-blocking vaccine. Nature Communications (2021)