Research presented at the annual meeting of the American Society of Tropical Medicine and Hygiene suggests that infecting mosquitoes with the disease can turn children infected with malaria into super spreaders. Additionally, children who spread infection are found to be asymptomatic.
Malaria is usually transmitted by three species of mosquito twice a year during the rainy season. Young asymptomatic children can now be added to the spread of the disease. Researchers have yet to determine whether or not the human-to-mosquito transmission results make the malaria more contagious.
If asymptomatic children transmit malaria to mosquitoes, the infected mosquitoes can infect other people in the area. The study was conducted on children in Tororo, Uganda, where the team discovered that children between the ages of five and 15 were the leading cause of mosquitoes infected with malaria.
Fortunately, said Chiara Andolina of Radboud University, the region they studied has made efforts to control the spread of malaria. Without these efforts, the young asymptomatic children can trigger a malaria epidemic.
According to the Serious Malaria Observatory, Uganda has the third highest cases of malaria in the world. In 2017 and 2018, efforts to prevent malaria resulted in a reduction in cases by 1.5 million, or 11%.
Big investments in malaria control naturally reduce the burden of malaria, Bousema said. “But to completely eradicate malaria, scientists need to find and remove any remaining hiding spots for the parasite.”
531 adults and children were monitored for malaria for two years. Malaria screenings were performed and blood samples examined each month.
After experiments in the laboratory where mosquitoes were given infected blood samples, the results showed that over 60% of infections were traced back to four asymptomatic children. Two of the infected children were under five years old.
In total, there were 148 cases of malaria with 110 asymptomatic cases. Blood samples were then given to mosquitos and transferred to a container in which they could collect blood from a skin-like membrane. After the preparation, the mosquitoes were examined for infection. 99.04% of the infections came from asymptomatic blood samples.
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While symptomatic patients have access to a clinic and can be treated before the disease is spread to mosquitoes, the challenge now is to identify asymptomatic people with malaria.
Teun Bousema said, “Asymptomatic infections really dominated children. And school children kind of have longer-lasting infections.” Avoiding the resurgence of malaria in the region should place a special focus on school-age children.
For example, frequent malaria screenings and treatments should be offered in schools to significantly reduce the onset of the disease. Mosquito nets are also typically used by pregnant women and children under the age of five. According to the authors, more preventive measures need to be taken for school-age children so that they do not become infected and potentially infect others through human-to-mosquito transmission.
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