Data Dialogue: Kelsey Sumner, UNC Epidemiology

Implications of asymptomatic Plasmodium falciparum infections for future symptomatic malaria infection and onward transmission in Western Kenya

Over 70% of Kenya's population lives in a high transmission area of Plasmodium falciparum malaria, leading to a high amount of malarial deaths in the region. In response, intervention efforts have made large strides to reduce the burden of malaria in high transmission areas like Western Kenya. Yet, malaria has persisted, making it increasingly important to identify remaining malaria reservoirs. Asymptomatic malaria has been hypothesized to be a significant source, or reservoir, of sustained malaria transmission, but the amount of onward transmission caused by asymptomatic malaria has not been sufficiently quantified. Furthermore, the relationship between current asymptomatic malaria and future symptomatic infections is still poorly understood. We aim to explore the natural history of asymptomatic P. falciparuminfection and its relationship to mosquito transmission and symptomatic malaria infection in Webuye, Western Kenya over 3 years. Our longitudinal study will answer two key questions for asymptomatic malaria infections: 1) Do asymptomatic malaria infections protect against future symptomatic infections from the same or different malaria infections within an individual? 2) Are asymptomatic malaria infections a large reservoir for future malaria infections within the population?