Description
Introduction-Objectives: Asymptomatic malaria infections must be understood for complete malaria control. Malaria transmission relies on asymptomatic Plasmodium falciparum carriers, especially youngsters. The link between asymptomatic carriage and clinical malaria risk is complicated and varies by transmission circumstances. Asymptomatic carriers and clinical malaria risk in Koulikoro, Mali, are examined in this study.
Methodology: Data were gathered from 2019 to 2020 in nine healthcare sites in Koulikoro Heath district, Mali. Participants' fingertip blood was used to detect clinical malaria using a quick diagnostic test, estimate asymptomatic carriage and malaria parasitemia with a thick smear using microscopy, and estimate hemoglobin levels. Asymptomatic carriage risk variables such as age, gender, and residency zone were examined using ORs and 95% CIs. Poisson regression was used to investigate the relationship between asymptomatic carriage and clinical malaria risk throughout the transmission season.
Results-discussions: Asymptomatic malaria was 10.2% (571/5,619) in 2019 and 14.1% (629/4,457) in 2020. Asymptomatic P. falciparum carriage was substantially greater in children aged 5–9 years (2019: aOR=1.68; 95% CI [1.40, 2.03] & 2020: 1.39, 1.99]) and in the riverbank zone (2019: 3.27; 95% CI [2.71, 3.97] & 2020emphasized text: 1.87). Age and residence zone affected anemia prevalence, with higher rates in children under 5 years old (p<0.001) and riverine areas (p=0.006). Children aged 5–9 years old had a substantially higher clinical malaria incidence of 28.0% during the transmission season compared to children under five years old (20.6%) (p<0.001). During the rainy season, asymptomatic carriers at the end of the dry season had a greater risk of clinical malaria (IR = 1.24; 95% CI [1.10, 1.40]; p<0.001), with a stronger link in high transmission zones (IR = 1.41; 95% CI [1.21, 1.64].
Conclusions: Asymptomatic P. falciparum carriage in the dry season increased the probability of clinical malaria in the rainy season. The infectious reservoir could be cleaned before administering seasonal malaria chemoprevention (SMC) drugs to eliminate malaria. Control measures such as SMC should also be extended to school-age children to reduce the burden of the disease.
Key words: malaria, asymptomatic carriage, anemia, risk factors, Mali.
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