{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T02:10:58Z","timestamp":1780452658390,"version":"3.54.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T00:00:00Z","timestamp":1613174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["NER\/55\/2015-ECD-I"],"award-info":[{"award-number":["NER\/55\/2015-ECD-I"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Malaria elimination requires targeting asymptomatic and low-density Plasmodium infections that largely remain undetected. Therefore we conducted a cross-sectional study to estimate the burden of asymptomatic and low-density Plasmodium infection using conventional and molecular diagnostics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 9118 participants, irrespective of age and sex, were screened for malaria using rapid diagnostic tests (RDTs), microscopy and polymerase chain reaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the participants, 707 presented with symptoms and 8411 without symptoms, of which Plasmodium was present in 15.6% (110\/707) and 8.1% (681\/8411), respectively. Low-density infection was found in 5.1% (145\/2818) of participants and 8327 of 9118 were Plasmodium negative. Endemicity was propotional to asymptomatic infections (high endemicity 11.1% [404\/3633] vs low endemicity 5.8% [277\/4778]; odds ratio [OR] 2.0 [95% confidence interval {CI} 1.7 to 2.4]) but inversely related to low-density infection (high endemicity 3.7% [57\/1545] vs low endemicity 6.9% [88\/1273]; OR 1.9 [95% CI 1.4 to 2.7]). The spleen rate in children 2\u20139\u00a0y of age was 17.9% (602\/3368) and the enlarged spleen index was 1.6. Children between 8 and 14\u00a0y showed higher odds for asymptomatic (adjusted OR [aOR] 1.75 [95% CI 1.4 to 2.2]) and low-density infections (aOR 0.63 [95% CI 0.4 to 1.0)] than adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The prevalence of asymptomatic and low-density Plasmodium infection undermines the usefulness of standard diagnostic tools used by health agencies. This necessitates deploying molecular tools in areas where malaria microscopy\/RDTs indicate a dearth of infection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/trab017","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T12:14:21Z","timestamp":1611058461000},"page":"1198-1206","source":"Crossref","is-referenced-by-count":11,"title":["Asymptomatic low-density <i>Plasmodium<\/i> infection during non-transmission season: a community-based cross-sectional study in two districts of North Eastern Region, India"],"prefix":"10.1093","volume":"115","author":[{"given":"Hari","family":"Shankar","sequence":"first","affiliation":[{"name":"Indian Council of Medical Research\u2013National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobhan","family":"Phookan","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research\u2013National 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Prakash","family":"Yadav","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research\u2013National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guru Prasad","family":"Sharma","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research\u2013National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuldeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research\u2013National Institute of Malaria Research Field Unit, Guwahati 781022, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research, Ansari Nagar, New Delhi 110029, 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