“Asymptomatic” Malaria: A Chronic and Debilitating Infection That Should Be Treated

Are afebrile malaria infections truly asymptomatic, benign, or even beneficial to the individual? The evidence suggests the contrary.

So-called “asymptomatic” malaria infections are associated with recurrent episodes of symptomatic parasitemia, chronic anemia, maternal and neonatal mortality, co-infection with invasive bacterial disease, cognitive impairment, and ongoing transmission of the parasite.

“Asymptomatic” malaria infections have significant health and societal consequences, and we propose that they should be renamed “chronic” malaria infections.

Targeting chronic malaria infections poses major scientific, operational, and ethical challenges.

We call for the malaria community to work with malaria control and elimination programs to target all malaria infections, irrespective of their density or presentation. The operational challenges to detect and treat chronic infections are significant, but accomplishing this is likely to result in substantial gains to both the individual and society.