Abstract:
Background: We investigated the prevalence of sub-microscopic Plasmodium falciparum infections and gametocyte
carriage in asymptomatic individuals in Navrongo in northern Ghana, an area of seasonal malaria transmission.
Design: A cross sectional study of 209 randomly selected participants of all age-groups was conducted in February
and March, 2015.
Methods: Capillary blood samples collected from these individuals were used for the detection of both asexual and
gametocyte stage parasites by microscopy, reverse transcriptase polymerase chain reaction (RT-PCR) and conventional
nested PCR methods. The prevalence data as determined by microscopy and molecular methods were compared
using chi-square tests.
Results: Parasitaemia from these asymptomatic infections ranged from 40 to 3,520 parasites/𝜇l of blood (geometric
mean parasitaemia = 732 parasites/𝜇l). The prevalence of asymptomatic P. falciparum carriage was 4.8% (10/209)
and 13.9% (29/209) using microscopy and RT-PCR respectively. The overall prevalence of sub-microscopic infections
in the total number of samples analysed was 9.1% (19/209) and 66% (19/29) of the asymptomatic infections.
P. falciparum gametocytemia detected by microscopy was 1% (2/209) and 3.8% (8/209) by PCR.
Conclusion: This is the first report of sub-microscopic asexual and gametocytes infections in the dry season in a
seasonal malaria transmission area in Ghana. It has established that persistent latent malaria infections occur and that
these could supply the source of parasites for the next transmission season. The findings highlight the presence of
sub-microscopic infections and therefore the need for active case detection surveillance to eliminate "asymptomatic
reservoir" parasites and consequently break the transmission of the disease in Ghana.