Koepfli, CristianOme-Kaius, MariaJally, ShadrachMalau, ElishebaMaripal, SamuelGinny, JasonTiminao, LincolnKattenberg, Johanna HelenaObadia, ThomasWhite, Michael T.Rarau, PatriciaSenn, NicolasBarry, Alyssa E.Kazura, James W.Mueller, IvoRobinson, Leanne J.2018-01-122018-01-122017-09-190022-1899https://hdl.handle.net/2445/119009Background: The scale-up of effective malaria control in the last decade has resulted in a substantial decline in the incidence of clinical malaria in many countries. The effects on the proportions of asymptomatic and submicroscopic infections, and on transmission potential are yet poorly understood. Methods: In Papua New Guinea, vector control has been intensified since 2008, and improved diagnosis and treatment introduced in 2012. Cross-sectional surveys were conducted in Madang Province in 2006 (n=1280), 2010 (n=2117) and 2014 (n=2516). Infections were quantified by highly sensitive qPCR and gametocytes by RT-qPCR. Results: P. falciparum prevalence by qPCR decreased from 42% in 2006 to 9% in 2014. P. vivax prevalence decreased from 42% in 2006 to 13% in 2010, but then increased to 20% in 2014. Parasite densities decreased 5-fold from 2006 to 2010; 72% of P. falciparum and 87% of P. vivax infections were submicroscopic in 2014. Gametocyte density and positivity correlated closely with parasitemia, and population gametocyte prevalence decreased 3-fold for P. falciparum and 29% for P. vivax from 2010 to 2014. Conclusions: Sustained control has resulted in reduced transmission potential but an increasing proportion of gametocyte carriers are asymptomatic and submicroscopic and represent a challenge to malaria control.10 p.application/pdfengcc by-nc-nd (c) Koepfli et al., 2017http://creativecommons.org/licenses/by-nc-nd/3.0/es/MalàriaPapua Nova GuineaMalariaPapua New Guineainfo:eu-repo/semantics/article2017-11-01info:eu-repo/semantics/openAccess