Molecular and Serological Survey of Asymptomatic Malaria Infection in Endemic Area Sistan and Baluchestan Province in East of Iran

The presence of asymptomatic malaria infection in endemic areas and misdiagnosis can lead to failure in malaria eradication strategies. The present study was performed to evaluate the presence and the prevalence of asymptomatic carriers in the Khash and Mirjaveh district, formerly a high malaria transmission area in Sistan and Baluchistan Province [2019–2020] using microscopic methods, ELISA, RDT test, multiplex nested PCR and LAMP in Khash and Mirjaveh cities. The microscopic method was used as a standard gold method for the diagnosis of malaria. Finger-prick blood samples were collected from symptomless (n = 550) individuals residing in Khash and Mirjaveh district, eastern Iran, from July 2019 to March 2020. Thick and thin Giemsa-stained blood smears were negative for Plasmodium parasites. In addition, based on the ELISA test, 26 and 2 out of 525 samples (5%) were positive for P. vivax and P. falciparum antigens. Multiplex nested PCR and LAMP analysis, no P. vivax, P. falciparum and P. malaria parasites were detected among the studied individuals. In conclusion, malaria eradication program in Khash and Mirjaveh region is possible regardless of whether the parasitic carriers are asymptomatic.