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Klein Klouwenberg PM, Oyakhirome S, Schwarz NG, Glaser B, Issifou S, Kiessling G, Klopfer A, Kremsner PG, Langin M, Lassmann B, Necek M, Potschke M, Ritz A, Grobusch MP, 2005. Malaria and asymptomatic parasitaemia in Gabonese infants under the age of 3 months. Acta Trop 95 :81–85.
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Taylor T, Olola C, Valim C, Agbenyega T, Kremsner P, Krishna S, Kwiatkowski D, Newton C, Missinou M, Pinder M, Wypij D, 2006. Standardized data collection for multi-center clinical studies of severe malaria in African children: establishing the SMAC network. Trans R Soc Trop Med Hyg 100 :615–622.
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Dzeing-Ella A, Nze Obiang PC, Tchoua R, Planche T, Mboza B, Mbounja M, Muller-Roemer U, Jarvis J, Kendjo E, Ngou-Milama E, Kremsner PG, Krishna S, Kombila M, 2005. Severe falciparum malaria in Gabonese children: clinical and laboratory features. Malar J 4 :1.
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Missinou MA, Lell B, Kremsner PG, 2003. Uncommon asymptomatic Plasmodium falciparum infections in Gabonese children. Clin Infect Dis 36 :1198–1202.
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Grobusch MP, Kremsner PG, 2005. Uncomplicated malaria. Curr Top Microbiol Immunol 295 :83–104.
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Gupta S, Snow RW, Donnelly CA, Marsh K, Newbold C, 1999. Immunity to non-cerebral severe malaria is acquired after one or two infections. Nat Med 5 :340–343.
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Miller LH, Good MF, Milon G, 1994. Malaria pathogenesis. Science 264 :1878–1883.
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Moody A, 2002. Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev 15 :66–78.
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Grobusch MP, Hanscheid T, Gobels K, Slevogt H, Zoller T, Rogler G, Teichmann D, 2003. Comparison of three antigen detection tests for diagnosis and follow-up of falciparum malaria in travellers returning to Berlin, Germany. Parasitol Res 89 :354–357.
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Grobusch MP, Alpermann U, Schwenke S, Jelinek T, Warhurst DC, 1999. False-positive rapid tests for malaria in patients with rheumatoid factor. Lancet 353 :297.
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Cheng Q, Lawrence G, Reed C, Stowers A, Ranford-Cartwright L, Creasey A, Carter R, Saul A, 1997. Measurement of Plasmodium falciparum growth rates in vivo: a test of malaria vaccines. Am J Trop Med Hyg 57 :495–500.
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Wildling E, Winkler S, Kremsner PG, Brandts C, Jenne L, Wernsdorfer WH, 1995. Malaria epidemiology in the province of Moyen Ogoov, Gabon. Trop Med Parasitol 46 :77–82.
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Sylla EH, Kun JF, Kremsner PG, 2000. Mosquito distribution and entomological inoculation rates in three malaria-endemic areas in Gabon. Trans R Soc Trop Med Hyg 94 :652–656.
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Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG, 2001. Comparison of methods for the rapid laboratory assessment of children with malaria. Am J Trop Med Hyg 65 :599–602.
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Jarra W, Snounou G, 1998. Only viable parasites are detected by PCR following clearance of rodent malarial infections by drug treatment or immune responses. Infect Immun 66 :3783–3787.
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Tjitra E, Suprianto S, McBroom J, Currie BJ, Anstey NM, 2001. Persistent ICT malaria P.f/P.v panmalarial and HRP2 antigen reactivity after treatment of Plasmodium falciparum malaria is associated with gametocytemia and results in false-positive diagnoses of Plasmodium vivax in convalescence. J Clin Microbiol 39 :1025–1031.
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Metzger WG, Mordmuller BG, Kremsner PG, 1995. Malaria pigment in leucocytes. Trans R Soc Trop Med Hyg 89 :637–638.
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Alves FP, Gil LH, Marrelli MT, Ribolla PE, Camargo EP, da Silva LH, 2005. Asymptomatic carriers of Plasmodium spp. as infection source for malaria vector mosquitoes in the Brazilian Amazon. J Med Entomol 42 :777–779.
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High Prevalence of Asymptomatic Plasmodium falciparum Infection in Gabonese Adults
Plasmodium falciparum, the most common malarial parasite in sub-Saharan Africa, accounts for a high number of deaths in children less than five years of age. In malaria-endemic countries with stable transmission, semi-immunity is usually acquired after childhood. For adults, severe malaria is rare. Infected adults have either uncomplicated malaria or asymptomatic parasitemia. During a period of one year, we screened 497 afebrile males to investigate the prevalence of asymptomatic P. falciparum parasitemia in villages near Lambaréné, Gabon by use of three different methods. A total of 52% of the individuals had parasites detected by a subtelomeric variable open reading frame polymerase chain reaction (stevor-PCR), 27% of the rapid diagnostic test results were positive, and 12% of the thick blood smears with low parasitemias had P. falciparum. Most positive cases were only detected by the stevor-PCR. Asymptomatic P. falciparum parasitemia in adults living in a malaria-endemic country is frequent.