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We report the impact screening-and-treatment of asymptomatic Malawian schoolchildren (n\u2009=\u2009364 in the rainy season and 341 in the dry season) had on gametocyte\u2014the parasite stage responsible for human-to-mosquito transmission\u2014carriage. We used concomitant household-based surveys to predict the potential reduction in transmission in the surrounding community. Among 253 students with\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    infections at screening, 179 (71%) had infections containing gametocytes detected by\n                    <jats:italic>Pfs<\/jats:italic>\n                    25 qRT-PCR. 84% of gametocyte-containing infections were detected by malaria rapid diagnostic test. While the gametocyte prevalence remained constant in untreated children, treatment with artemether-lumefantrine reduced the gametocyte prevalence (p\u2009&lt;\u20090.0001) from 51.8 to 9.7% and geometric mean gametocyte density (p\u2009=\u20090.008) from 0.52 to 0.05 gametocytes\/microliter. In community surveys, 46% of all gametocyte-containing infections were in school-age children, who comprised only 35% of the population. Based on these estimates six weeks after the intervention, the gametocyte burden in the community could be reduced by 25\u201355% depending on the season and the measure used to characterize gametocyte carriage. Thus, school-based interventions to treat asymptomatic infections may be a high-yield approach to not only improve the health of schoolchildren, but also decrease malaria transmission.\n                  <\/jats:p>","DOI":"10.1038\/s41598-021-86450-5","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T07:06:58Z","timestamp":1616656018000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["School-based screening and treatment may reduce P. falciparum transmission"],"prefix":"10.1038","volume":"11","author":[{"given":"Lauren M.","family":"Cohee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Valim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna E.","family":"Coalson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nyambalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Chilombe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ngwira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Bauleni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl B.","family":"Seydel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark L.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrie E.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don P.","family":"Mathanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam K.","family":"Laufer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"key":"86450_CR1","unstructured":"World Health Organization. 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Increased gametocyte production and mosquito infectivity in chronic versus incident Plasmodium falciparum infections. medRxiv (2020). https:\/\/doi.org\/10.1101\/2020.04.08.20057927","DOI":"10.1101\/2020.04.08.20057927"},{"key":"86450_CR5","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1038\/nrmicro3364","volume":"12","author":"T Bousema","year":"2014","unstructured":"Bousema, T., Okell, L., Felger, I. & Drakeley, C. Asymptomatic malaria infections: Detectability, transmissibility and public health relevance. Nat. Rev. Microbiol. 12, 833\u2013840 (2014).","journal-title":"Nat. Rev. Microbiol."},{"key":"86450_CR6","doi-asserted-by":"crossref","unstructured":"malERA: An updated research agenda for characterising the reservoir and measuring transmission in malaria elimination and eradication. 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School-age children are a reservoir of malaria infection in Malawi. PLoS ONE 10, e0134061 (2015).","journal-title":"PLoS ONE"},{"key":"86450_CR10","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1186\/s12936-015-1056-x","volume":"14","author":"JI Nankabirwa","year":"2015","unstructured":"Nankabirwa, J. I. et al. Estimating malaria parasite prevalence from community surveys in Uganda: A comparison of microscopy, rapid diagnostic tests and polymerase chain reaction. Malar. J. 14, 528 (2015).","journal-title":"Malar. J."},{"key":"86450_CR11","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1186\/s12936-016-1482-4","volume":"15","author":"Z Zhou","year":"2016","unstructured":"Zhou, Z. et al. Assessment of submicroscopic infections and gametocyte carriage of Plasmodium falciparum during peak malaria transmission season in a community-based cross-sectional survey in western Kenya, 2012. Malar. J. 15, 421 (2016).","journal-title":"Malar. 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