Abstract:
t. Ultrasensitive PCR used in low-transmission malaria-endemic settings has revealed a much higher burden
of asymptomatic infections than that detected by rapid diagnostic tests (RDTs) or standard PCR, but there is limited
evidence as to whether this is the case in higher transmission settings. Using dried blood spots (DBS) collected among
319 schoolchildren in Bagamoyo, Tanzania, we found good correlation (Pearson’s R = 0.995) between Plasmodium
falciparum parasite densities detected by a DNA-based 18s rRNA real-time PCR (qPCR) and an RNA-based ultrasensitive
reverse transcriptase (RT)-PCR (usPCR) for the same target. Whereas prevalence by usPCR was higher than that found by
qPCR (37% versus 32%), the proportion of additionally detected low-density infections (median parasite density < 0.050
parasites/μL) represented an incremental increase. It remains unclear to what extent these low-density infections may
contribute to the infectious reservoir in different malaria transmission settings
