Sturrock HJ, Hsiang MS, Cohen JM, Smith DL, Greenhouse B, Bousema T, Gosling RD, 2013. Targeting asymptomatic malaria infections: active surveillance in control and elimination. PLoS Med 10: e1001467.
malERA Consultative Group on Monitoring, Evaluation, and Surveillance, 2011. A research agenda for malaria eradication: monitoring, evaluation, and surveillance. PLoS Med 8: e1000400.
Tusting LS, Bousema T, Smith DL, Drakeley C, 2014. Measuring changes in Plasmodium falciparum transmission: precision, accuracy and costs of metrics. Adv Parasitol 84: 151–208.
Khosa E, Kuonza LR, Kruger P, Maimela E, 2013. Towards the elimination of malaria in South Africa: a review of surveillance data in Mutale Municipality, Limpopo Province, 2005 to 2010. Malar J 12: 7.
Juma E, Zurovac D, 2011. Changes in health workers' malaria diagnosis and treatment practices in Kenya. Malar J 10: 1.
Olotu A, Fegan G, Williams TN, Sasi P, Ogada E, Bauni E, Wambua J, Marsh K, Borrmann S, Bejon P, 2010. Defining clinical malaria: the specificity and incidence of endpoints from active and passive surveillance of children in rural Kenya. PLoS ONE 5: e15569.
Afrane Y, Zhou G, Githeko A, Yan G, 2013. Utility of health facility-based malaria data for malaria surveillance. PLoS ONE 8: e54305.
Bousema T, Drakeley C, Gesase S, Hashim R, Magesa S, Mosha F, Otieno S, Carneiro I, Cox J, Msuya E, Kleinschmidt I, Maxwell C, Greenwood B, Riley E, Sauerwein R, Chandramohan D, Gosling R, 2010. Identification of hot spots of malaria transmission for targeted malaria control. J Infect Dis 201: 1764–1774.
Oduro AR, Bojang KA, Conway DJ, Corrah T, Greenwood BM, Schellenberg D, 2011. Health centre surveys as a potential tool for monitoring malaria epidemiology by area and over time. PLoS ONE 6: e26305.
Macedo de Oliveira A, Mutemba R, Morgan J, Streat E, Roberts J, Menon M, Mabunda S, 2011. Prevalence of malaria among patients attending public health facilities in Maputo City, Mozambique. Am J Trop Med Hyg 85: 1002–1007.
Okell LC, Bousema T, Griffin JT, Ouedraogo AL, Ghani AC, Drakeley CJ, 2012. Factors determining the occurrence of submicroscopic malaria infections and their relevance for control. Nat Commun 3: 1237.
Okell LC, Ghani AC, Lyons E, Drakeley CJ, 2009. Submicroscopic infection in Plasmodium falciparum-endemic populations: a systematic review and meta-analysis. J Infect Dis 200: 1509–1517.
Lindblade KA, Steinhardt L, Samuels A, Kachur SP, Slutsker L, 2013. The silent threat: asymptomatic parasitemia and malaria transmission. Expert Rev Anti Infect Ther 11: 623–639.
Nguyen HV, van den Eede P, van Overmeir C, Thang ND, Hung le X, D'Alessandro U, Erhart A, 2012. Marked age-dependent prevalence of symptomatic and patent infections and complexity of distribution of human Plasmodium species in central Vietnam. Am J Trop Med Hyg 87: 989–995.
Baliraine FN, Afrane YA, Amenya DA, Bonizzoni M, Menge DM, Zhou G, Zhong D, Vardo-Zalik AM, Githeko AK, Yan G, 2009. High prevalence of asymptomatic Plasmodium falciparum infections in a highland area of western Kenya: a cohort study. J Infect Dis 200: 66–74.
Harris I, Sharrock WW, Bain LM, Gray KA, Bobogare A, Boaz L, Lilley K, Krause D, Vallely A, Johnson ML, Gatton ML, Shanks GD, Cheng Q, 2010. A large proportion of asymptomatic Plasmodium infections with low and sub-microscopic parasite densities in the low transmission setting of Temotu Province, Solomon Islands: challenges for malaria diagnostics in an elimination setting. Malar J 9: 254.
Karl S, Gurarie D, Zimmerman PA, King CH, St Pierre TG, Davis TM, 2011. A sub-microscopic gametocyte reservoir can sustain malaria transmission. PLoS ONE 6: e20805.
Bousema T, Stevenson J, Baidjoe A, Stresman G, Griffin JT, Kleinschmidt I, Remarque EJ, Vulule J, Bayoh N, Laserson K, Desai M, Sauerwein R, Drakeley C, Cox J, 2013. The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial. Trials 14: 36.
Sanitation MoPHa, 2011. 2010 Kenya Malaria Indicator Survey. Nairobi, Kenya: Ministry of Public Health and Sanitation.
Stevenson JC, Stresman GH, Gitonga CW, Gillig J, Owaga C, Marube E, Odongo W, Okoth A, China P, Oriango R, Brooker SJ, Bousema T, Drakeley C, Cox J, 2013. Reliability of school surveys in estimating geographic variation in malaria transmission in the western Kenyan highlands. PLoS ONE 8: e77641.
Stevenson J, St. Laurent B, Lobo NF, Cooke MK, Kahindi SC, Oriango R, Harback RE, Cox J, Drakeley C, 2012. Novel vectors of malaria parasites in the western highlands of Kenya. Emerg Infect Dis 18: 1547–1549.
WHO, 2012. Malaria Rapid Diagnostic Test Performance: Results of WHO Product Testing of Malaria RDTs: Round 4 (2012). Geneva: World Health Organization.
Sanitation MoPHa, 2010. National Guidelines for HIV Testing and Counselling in Kenya. Nairobi, Kenya: Ministry of Public Health and Sanitation.
Baidjoe A, Stone W, Ploemen I, Shagari S, Grignard L, Osoti V, Makori E, Stevenson J, Kariuki S, Sutherland C, Sauerwein R, Cox J, Drakeley C, Bousema T, 2013. Combined DNA extraction and antibody elution from filter papers for the assessment of malaria transmission intensity in epidemiological studies. Malar J 12: 272.
Corran P, Coleman P, Riley E, Drakeley C, 2007. Serology: a robust indicator of malaria transmission intensity? Trends Parasitol 23: 575–582.
Snounou G, Viriyakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosario VE, Thaithong S, Brown KN, 1993. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61: 315–320.
Koepfli C, Ross A, Kiniboro B, Smith TA, Zimmerman PA, Siba P, Mueller I, Felger I, 2011. Multiplicity and diversity of Plasmodium vivax infections in a highly endemic region in Papua New Guinea. PLoS Negl Trop Dis 5: e1424.
Koepfli C, Schoepflin S, Bretscher M, Lin E, Kiniboro B, Zimmerman PA, Siba P, Smith TA, Mueller I, Felger I, 2011. How much remains undetected? Probability of molecular detection of human Plasmodia in the field. PLoS ONE 6: e19010.
Liljander A, Wiklund L, Falk N, Kweku M, Martensson A, Felger I, Farnert A, 2009. Optimization and validation of multi-coloured capillary electrophoresis for genotyping of Plasmodium falciparum merozoite surface proteins (msp1 and 2). Malar J 8: 78.
McMorrow ML, Aidoo M, Kachur SP, 2011. Malaria rapid diagnostic tests in elimination settings - can they find the last parasite? Clin Microbiol Infect 17: 1624–1631.
Stresman G, Stevenson J, Owaga C, Marube E, Anyango C, Drakeley C, Bousema T, Cox J, 2014. Validation of three geolocation strategies for health-facility attendees for research and public health surveillance in a rural setting in western Kenya. Epidemiol Infect 142: 1978–1989.
Barry AE, Schultz L, Senn N, Nale J, Kiniboro B, Siba PM, Mueller I, Reeder JC, 2013. High levels of genetic diversity of Plasmodium falciparum populations in Papua New Guinea despite variable infection prevalence. Am J Trop Med Hyg 88: 718–725.
Fox E, Strickland GT, Sarwar M, Shamim M, Zafar-Latif A, Khaliq AA, 1987. Reliable assessment of malaria prevalence through village clinics. Trans R Soc Trop Med Hyg 81: 115–117.
Cotter C, Sturrock HJW, Hsiang MS, Liu J, Phillips AA, Hwang J, Gueye CS, Fullman N, Gosling RD, Feachem RGA, 2013. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet 382: 900–911.
Stresman GH, 2010. Beyond temperature and precipitation: ecological risk factors that modify malaria transmission. Acta Trop 116: 167–172.
Stresman GH, Kamanga A, Moono P, Hamapumbu H, Mharakurwa S, Kobayashi T, Moss WJ, Shiff C, 2010. A method of active case detection to target reservoirs of asymptomatic malaria and gametocyte carriers in a rural area in Southern Province, Zambia. Malar J 9: 265.
WHO, 2012. Disease Surveilance for Malaria Control: An Operational Manual. Geneva: World Health Organization.
Mosha JF, Sturrock HJ, Greenhouse B, Greenwood B, Sutherland CJ, Gadalla N, Atwal S, Drakeley C, Kibiki G, Bousema T, Chandramohan D, Gosling R, 2013. Epidemiology of subpatent Plasmodium falciparum infection: implications for detection of hotspots with imperfect diagnostics. Malar J 12: 221.
Beshir KB, Sutherland CJ, Sawa P, Drakeley CJ, Okell L, Mweresa CK, Omar SA, Shekalaghe SA, Kaur H, Ndaro A, Chilongola J, Schallig HD, Sauerwein RW, Hallett RL, Bousema T, 2013. Residual Plasmodium falciparum parasitemia in Kenyan children after artemisinin-combination therapy is associated with increased transmission to mosquitoes and parasite recurrence. J Infect Dis 208: 2017–2024.
Nassir E, Abdel-Muhsin AM, Suliaman S, Kenyon F, Kheir A, Geha H, Ferguson HM, Walliker D, Babiker HA, 2005. Impact of genetic complexity on longevity and gametocytogenesis of Plasmodium falciparum during the dry and transmission-free season of eastern Sudan. Int J Parasitol 35: 49–55.
Iriemenam NC, Shah M, Gatei W, van Eijk AM, Ayisi J, Kariuki S, Vanden Eng J, Owino SO, Lal AA, Omosun YO, Otieno K, Desai M, ter Kuile FO, Nahlen B, Moore J, Hamel MJ, Ouma P, Slutsker L, Shi YP, 2012. Temporal trends of sulphadoxine-pyrimethamine (SP) drug-resistance molecular markers in Plasmodium falciparum parasites from pregnant women in western Kenya. Malar J 11: 134.
Zhong D, Afrane Y, Githeko A, Cui L, Menge DM, Yan G, 2008. Molecular epidemiology of drug-resistant malaria in western Kenya highlands. BMC Infect Dis 8: 105.
Alves FP, Durlacher RR, Menezes MJ, Krieger H, Silva LH, Camargo EP, 2002. High prevalence of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in native Amazonian populations. Am J Trop Med Hyg 66: 641–648.
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Abstract Views | 954 | 641 | 46 |
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In endemic settings, health facility surveys provide a convenient approach to estimating malaria transmission intensity. Typically, testing for malaria at facilities is performed on symptomatic attendees, but asymptomatic infections comprise a considerable proportion of the parasite reservoir. We sampled individuals attending five health facilities in the western Kenyan highlands. Malaria prevalence by rapid diagnostic test (RDT) was 8.6–32.9% in the health facilities. Of all polymerase chain reaction-positive participants, 46.4% (95% confidence interval [95% CI] = 42.6–50.2%) of participants had infections that were RDT-negative and asymptomatic, and 55.9% of those infections consisted of multiple parasite clones as assessed by merozoite surface protein-2 genotyping. Subpatent infections were more common in individuals reporting the use of non-artemisinin–based antimalarials in the 2 weeks preceding the survey (odds ratio = 2.49, 95% CI = 1.04–5.92) compared with individuals not reporting previous use of antimalarials. We observed a large and genetically complex pool of subpatent parasitemia in the Kenya highlands that must be considered in malaria interventions.
Financial support: This research was funded by the Bill and Melinda Gates Foundation as part of Malaria Transmission Consortium Grant 45114. C.D. is supported by Wellcome Trust Grant 091924. T.B. is supported by Grand Challenge Grant OPP1024438 from the Bill and Melinda Gates Foundation.
Authors' addresses: Gillian H. Stresman and Chris Drakeley, Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mails: Gillian.Stresman@lshtm.ac.uk and Chris.Drakeley@lshtm.ac.uk. Jennifer C. Stevenson, Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: jennyc.stevenson@macharesearch.org. Nnenna Ngwu, St. Georges Healthcare National Health Service (NHS) Trust, London, United Kingdom, E-mail: nsongwu@gmail.com. Elizabeth Marube, Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya, E-mail: Emarube@kemricdc.org. Chrispin Owaga, Safe Water and AIDS Project, Kisumu, Kenya, E-mail: cowage@gmail.com. Teun Bousema, Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom, and Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands, E-mail: Teun.Bousema@lshtm.ac.uk. Jonathan Cox, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mail: Jonathan.Cox@lshtm.ac.uk.
Sturrock HJ, Hsiang MS, Cohen JM, Smith DL, Greenhouse B, Bousema T, Gosling RD, 2013. Targeting asymptomatic malaria infections: active surveillance in control and elimination. PLoS Med 10: e1001467.
malERA Consultative Group on Monitoring, Evaluation, and Surveillance, 2011. A research agenda for malaria eradication: monitoring, evaluation, and surveillance. PLoS Med 8: e1000400.
Tusting LS, Bousema T, Smith DL, Drakeley C, 2014. Measuring changes in Plasmodium falciparum transmission: precision, accuracy and costs of metrics. Adv Parasitol 84: 151–208.
Khosa E, Kuonza LR, Kruger P, Maimela E, 2013. Towards the elimination of malaria in South Africa: a review of surveillance data in Mutale Municipality, Limpopo Province, 2005 to 2010. Malar J 12: 7.
Juma E, Zurovac D, 2011. Changes in health workers' malaria diagnosis and treatment practices in Kenya. Malar J 10: 1.
Olotu A, Fegan G, Williams TN, Sasi P, Ogada E, Bauni E, Wambua J, Marsh K, Borrmann S, Bejon P, 2010. Defining clinical malaria: the specificity and incidence of endpoints from active and passive surveillance of children in rural Kenya. PLoS ONE 5: e15569.
Afrane Y, Zhou G, Githeko A, Yan G, 2013. Utility of health facility-based malaria data for malaria surveillance. PLoS ONE 8: e54305.
Bousema T, Drakeley C, Gesase S, Hashim R, Magesa S, Mosha F, Otieno S, Carneiro I, Cox J, Msuya E, Kleinschmidt I, Maxwell C, Greenwood B, Riley E, Sauerwein R, Chandramohan D, Gosling R, 2010. Identification of hot spots of malaria transmission for targeted malaria control. J Infect Dis 201: 1764–1774.
Oduro AR, Bojang KA, Conway DJ, Corrah T, Greenwood BM, Schellenberg D, 2011. Health centre surveys as a potential tool for monitoring malaria epidemiology by area and over time. PLoS ONE 6: e26305.
Macedo de Oliveira A, Mutemba R, Morgan J, Streat E, Roberts J, Menon M, Mabunda S, 2011. Prevalence of malaria among patients attending public health facilities in Maputo City, Mozambique. Am J Trop Med Hyg 85: 1002–1007.
Okell LC, Bousema T, Griffin JT, Ouedraogo AL, Ghani AC, Drakeley CJ, 2012. Factors determining the occurrence of submicroscopic malaria infections and their relevance for control. Nat Commun 3: 1237.
Okell LC, Ghani AC, Lyons E, Drakeley CJ, 2009. Submicroscopic infection in Plasmodium falciparum-endemic populations: a systematic review and meta-analysis. J Infect Dis 200: 1509–1517.
Lindblade KA, Steinhardt L, Samuels A, Kachur SP, Slutsker L, 2013. The silent threat: asymptomatic parasitemia and malaria transmission. Expert Rev Anti Infect Ther 11: 623–639.
Nguyen HV, van den Eede P, van Overmeir C, Thang ND, Hung le X, D'Alessandro U, Erhart A, 2012. Marked age-dependent prevalence of symptomatic and patent infections and complexity of distribution of human Plasmodium species in central Vietnam. Am J Trop Med Hyg 87: 989–995.
Baliraine FN, Afrane YA, Amenya DA, Bonizzoni M, Menge DM, Zhou G, Zhong D, Vardo-Zalik AM, Githeko AK, Yan G, 2009. High prevalence of asymptomatic Plasmodium falciparum infections in a highland area of western Kenya: a cohort study. J Infect Dis 200: 66–74.
Harris I, Sharrock WW, Bain LM, Gray KA, Bobogare A, Boaz L, Lilley K, Krause D, Vallely A, Johnson ML, Gatton ML, Shanks GD, Cheng Q, 2010. A large proportion of asymptomatic Plasmodium infections with low and sub-microscopic parasite densities in the low transmission setting of Temotu Province, Solomon Islands: challenges for malaria diagnostics in an elimination setting. Malar J 9: 254.
Karl S, Gurarie D, Zimmerman PA, King CH, St Pierre TG, Davis TM, 2011. A sub-microscopic gametocyte reservoir can sustain malaria transmission. PLoS ONE 6: e20805.
Bousema T, Stevenson J, Baidjoe A, Stresman G, Griffin JT, Kleinschmidt I, Remarque EJ, Vulule J, Bayoh N, Laserson K, Desai M, Sauerwein R, Drakeley C, Cox J, 2013. The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial. Trials 14: 36.
Sanitation MoPHa, 2011. 2010 Kenya Malaria Indicator Survey. Nairobi, Kenya: Ministry of Public Health and Sanitation.
Stevenson JC, Stresman GH, Gitonga CW, Gillig J, Owaga C, Marube E, Odongo W, Okoth A, China P, Oriango R, Brooker SJ, Bousema T, Drakeley C, Cox J, 2013. Reliability of school surveys in estimating geographic variation in malaria transmission in the western Kenyan highlands. PLoS ONE 8: e77641.
Stevenson J, St. Laurent B, Lobo NF, Cooke MK, Kahindi SC, Oriango R, Harback RE, Cox J, Drakeley C, 2012. Novel vectors of malaria parasites in the western highlands of Kenya. Emerg Infect Dis 18: 1547–1549.
WHO, 2012. Malaria Rapid Diagnostic Test Performance: Results of WHO Product Testing of Malaria RDTs: Round 4 (2012). Geneva: World Health Organization.
Sanitation MoPHa, 2010. National Guidelines for HIV Testing and Counselling in Kenya. Nairobi, Kenya: Ministry of Public Health and Sanitation.
Baidjoe A, Stone W, Ploemen I, Shagari S, Grignard L, Osoti V, Makori E, Stevenson J, Kariuki S, Sutherland C, Sauerwein R, Cox J, Drakeley C, Bousema T, 2013. Combined DNA extraction and antibody elution from filter papers for the assessment of malaria transmission intensity in epidemiological studies. Malar J 12: 272.
Corran P, Coleman P, Riley E, Drakeley C, 2007. Serology: a robust indicator of malaria transmission intensity? Trends Parasitol 23: 575–582.
Snounou G, Viriyakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosario VE, Thaithong S, Brown KN, 1993. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61: 315–320.
Koepfli C, Ross A, Kiniboro B, Smith TA, Zimmerman PA, Siba P, Mueller I, Felger I, 2011. Multiplicity and diversity of Plasmodium vivax infections in a highly endemic region in Papua New Guinea. PLoS Negl Trop Dis 5: e1424.
Koepfli C, Schoepflin S, Bretscher M, Lin E, Kiniboro B, Zimmerman PA, Siba P, Smith TA, Mueller I, Felger I, 2011. How much remains undetected? Probability of molecular detection of human Plasmodia in the field. PLoS ONE 6: e19010.
Liljander A, Wiklund L, Falk N, Kweku M, Martensson A, Felger I, Farnert A, 2009. Optimization and validation of multi-coloured capillary electrophoresis for genotyping of Plasmodium falciparum merozoite surface proteins (msp1 and 2). Malar J 8: 78.
McMorrow ML, Aidoo M, Kachur SP, 2011. Malaria rapid diagnostic tests in elimination settings - can they find the last parasite? Clin Microbiol Infect 17: 1624–1631.
Stresman G, Stevenson J, Owaga C, Marube E, Anyango C, Drakeley C, Bousema T, Cox J, 2014. Validation of three geolocation strategies for health-facility attendees for research and public health surveillance in a rural setting in western Kenya. Epidemiol Infect 142: 1978–1989.
Barry AE, Schultz L, Senn N, Nale J, Kiniboro B, Siba PM, Mueller I, Reeder JC, 2013. High levels of genetic diversity of Plasmodium falciparum populations in Papua New Guinea despite variable infection prevalence. Am J Trop Med Hyg 88: 718–725.
Fox E, Strickland GT, Sarwar M, Shamim M, Zafar-Latif A, Khaliq AA, 1987. Reliable assessment of malaria prevalence through village clinics. Trans R Soc Trop Med Hyg 81: 115–117.
Cotter C, Sturrock HJW, Hsiang MS, Liu J, Phillips AA, Hwang J, Gueye CS, Fullman N, Gosling RD, Feachem RGA, 2013. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet 382: 900–911.
Stresman GH, 2010. Beyond temperature and precipitation: ecological risk factors that modify malaria transmission. Acta Trop 116: 167–172.
Stresman GH, Kamanga A, Moono P, Hamapumbu H, Mharakurwa S, Kobayashi T, Moss WJ, Shiff C, 2010. A method of active case detection to target reservoirs of asymptomatic malaria and gametocyte carriers in a rural area in Southern Province, Zambia. Malar J 9: 265.
WHO, 2012. Disease Surveilance for Malaria Control: An Operational Manual. Geneva: World Health Organization.
Mosha JF, Sturrock HJ, Greenhouse B, Greenwood B, Sutherland CJ, Gadalla N, Atwal S, Drakeley C, Kibiki G, Bousema T, Chandramohan D, Gosling R, 2013. Epidemiology of subpatent Plasmodium falciparum infection: implications for detection of hotspots with imperfect diagnostics. Malar J 12: 221.
Beshir KB, Sutherland CJ, Sawa P, Drakeley CJ, Okell L, Mweresa CK, Omar SA, Shekalaghe SA, Kaur H, Ndaro A, Chilongola J, Schallig HD, Sauerwein RW, Hallett RL, Bousema T, 2013. Residual Plasmodium falciparum parasitemia in Kenyan children after artemisinin-combination therapy is associated with increased transmission to mosquitoes and parasite recurrence. J Infect Dis 208: 2017–2024.
Nassir E, Abdel-Muhsin AM, Suliaman S, Kenyon F, Kheir A, Geha H, Ferguson HM, Walliker D, Babiker HA, 2005. Impact of genetic complexity on longevity and gametocytogenesis of Plasmodium falciparum during the dry and transmission-free season of eastern Sudan. Int J Parasitol 35: 49–55.
Iriemenam NC, Shah M, Gatei W, van Eijk AM, Ayisi J, Kariuki S, Vanden Eng J, Owino SO, Lal AA, Omosun YO, Otieno K, Desai M, ter Kuile FO, Nahlen B, Moore J, Hamel MJ, Ouma P, Slutsker L, Shi YP, 2012. Temporal trends of sulphadoxine-pyrimethamine (SP) drug-resistance molecular markers in Plasmodium falciparum parasites from pregnant women in western Kenya. Malar J 11: 134.
Zhong D, Afrane Y, Githeko A, Cui L, Menge DM, Yan G, 2008. Molecular epidemiology of drug-resistant malaria in western Kenya highlands. BMC Infect Dis 8: 105.
Alves FP, Durlacher RR, Menezes MJ, Krieger H, Silva LH, Camargo EP, 2002. High prevalence of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in native Amazonian populations. Am J Trop Med Hyg 66: 641–648.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 954 | 641 | 46 |
Full Text Views | 448 | 13 | 0 |
PDF Downloads | 115 | 17 | 0 |