{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:12:39Z","timestamp":1777673559904,"version":"3.51.4"},"posted":{"date-parts":[[2024,1,10]]},"group-title":"Epidemiology","reference-count":53,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,7,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    Recent molecular surveillance suggests an unexpectedly high prevalence of non-falciparum malaria in Africa. Malaria control is also challenged by undetected asymptomatic\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    malaria resulting in an undetectable reservoir for potential transmission. Context-specific surveillance of asymptomatic\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    and non-falciparum species is needed to properly inform malaria control programs.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    We performed quantitative real time PCR for four malaria species in 5,050 primarily adult individuals in Rwanda using the 2014-2015 Demographic Health Survey. We assessed correlates of infection by species to explore attributes associated with each species. Asymptomatic\n                    <jats:italic>P. ovale spp<\/jats:italic>\n                    .,\n                    <jats:italic>P. malariae, and P. falciparum<\/jats:italic>\n                    malaria infection had broad spatial distribution across Rwanda.\n                    <jats:italic>P. vivax<\/jats:italic>\n                    infection was rare.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Overall infection prevalence was 22.3% (95%CI [20.3, 24.3]), with\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    and non-falciparum at 16.3% [14.5, 18.1] and 8.0% [6.6, 9.3], respectively. Parasitemias tended to be low and mixed species infections were common, especially where malaria transmission and overall prevalence was the highest.\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    infection was associated with lower wealth, rural residence and low elevation. Fewer factors were significantly associated with non-falciparum malaria.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>\n                    Asymptomatic non-falciparum malaria and\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    malaria are common and widely distributed across Rwanda in adults. Continued molecular monitoring, preferably done by the national malaria control program, of\n                    <jats:italic>Plasmodium<\/jats:italic>\n                    diversity using routine survey samples is needed to strengthen malaria control.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.01.09.24301054","type":"posted-content","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T15:00:58Z","timestamp":1704898858000},"source":"Crossref","is-referenced-by-count":5,"title":["Prevalence of Asymptomatic non-Falciparum and Falciparum Malaria in the 2014-15 Rwanda Demographic Health Survey"],"prefix":"10.64898","author":[{"given":"Claudia","family":"Gaither","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1315-0908","authenticated-orcid":false,"given":"Camille","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Kirby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corine","family":"Karema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Gashema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1351-1020","authenticated-orcid":false,"given":"Samuel J.","family":"White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7824-9605","authenticated-orcid":false,"given":"Hillary M.","family":"Topazian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2498-4705","authenticated-orcid":false,"given":"David","family":"Geibrecht","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyaw","family":"Thwai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neeva Wernsman","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koby","family":"Boyter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tharcisse","family":"Munyaneza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude Mambo","family":"Muvunyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"De Dieu Butera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6899-8204","authenticated-orcid":false,"given":"Jeffrey A.","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Baptiste","family":"Mazarati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-0850","authenticated-orcid":false,"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025072223450467000_2024.01.09.24301054v3.1","unstructured":"World malaria report 2024. 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