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Background <p>Asymptomatic <i>Plasmodium falciparum</i> infections sustain malaria transmission and challenge elimination efforts. School-aged children may serve as a key reservoir, yet are often overlooked in malaria control programs.</p> Methods <p>A cross-sectional survey was conducted in July 2022 across Banfora, Orodara, and Gaoua districts (Burkina Faso), enrolling 1,127 children aged from 6&#xa0;months to 10&#xa0;years. Malaria diagnosis was performed using HRP2-based RDT, expert microscopy, and qPCR. Children with fever (&gt; 37.5&#xa0;°C) were excluded from asymptomatic analysis.</p> Results <p>Prevalence of asymptomatic <i>Plasmodium falciparum</i> infection was 28.0% by RDT and 31.9% by microscopy. Among school-aged children (5–10&#xa0;years), 66.5% tested positive by microscopy versus 21.6% in children under five. Gametocyte carriage reached 3.9% overall and was twice as high in school-aged children (67 vs. 32 gametocytes/μL). Microscopy outperformed RDT in sensitivity (76.7% vs. 67.7%), specificity (100% vs. 96.2%), and positive predictive value (100% vs. 83.8%) using qPCR as reference. Most infections were due to <i>P. falciparum</i> (98.2%), with mixed infections being rare.</p> Conclusion <p>School-aged children are a major reservoir for asymptomatic and potentially infectious malaria. Their inclusion in surveillance and control strategies is critical. Expert microscopy remains a reliable field tool to detect asymptomatic carriage in high-burden areas.</p>

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School-aged children as a silent reservoir of Plasmodium falciparum: findings from a cross-sectional survey conducted in Burkina Faso in 2022

  • 期刊论文

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  • 发表日期：

    2026年3月30日

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  • Casimire Wendlamita Tarama,
  • Harouna Soré,
  • Mamadou Samb Yade,
  • Denis Niyomwungere,
  • Siaka Débé,
  • Réné Kinda,
  • Adama Ganou,
  • Didier Ménard,
  • Adama Gansané

摘要

Background

Asymptomatic Plasmodium falciparum infections sustain malaria transmission and challenge elimination efforts. School-aged children may serve as a key reservoir, yet are often overlooked in malaria control programs.

Methods

A cross-sectional survey was conducted in July 2022 across Banfora, Orodara, and Gaoua districts (Burkina Faso), enrolling 1,127 children aged from 6 months to 10 years. Malaria diagnosis was performed using HRP2-based RDT, expert microscopy, and qPCR. Children with fever (> 37.5 °C) were excluded from asymptomatic analysis.

Results

Prevalence of asymptomatic Plasmodium falciparum infection was 28.0% by RDT and 31.9% by microscopy. Among school-aged children (5–10 years), 66.5% tested positive by microscopy versus 21.6% in children under five. Gametocyte carriage reached 3.9% overall and was twice as high in school-aged children (67 vs. 32 gametocytes/μL). Microscopy outperformed RDT in sensitivity (76.7% vs. 67.7%), specificity (100% vs. 96.2%), and positive predictive value (100% vs. 83.8%) using qPCR as reference. Most infections were due to P. falciparum (98.2%), with mixed infections being rare.

Conclusion

School-aged children are a major reservoir for asymptomatic and potentially infectious malaria. Their inclusion in surveillance and control strategies is critical. Expert microscopy remains a reliable field tool to detect asymptomatic carriage in high-burden areas.