Abstract
A detailed understanding of the human infectious reservoir is essential for improving malaria transmission-reducing interventions. Here we report a multi-regional assessment of population-wide malaria transmission potential based on 1209 mosquito feeding assays in endemic areas of Burkina Faso and Kenya. Across both sites, we identified 39 infectious individuals. In high endemicity settings, infectious individuals were identifiable by research-grade microscopy (92.6%; 25/27), whilst one of three infectious individuals in the lowest endemicity setting was detected by molecular techniques alone. The percentages of infected mosquitoes in the different surveys ranged from 0.05 (4/7716) to 1.6% (121/7749), and correlate positively with transmission intensity. We also estimated exposure to malaria vectors through genetic matching of blood from 1094 wild-caught bloodfed mosquitoes with that of humans resident in the same houses. Although adults transmitted fewer parasites to mosquitoes than children, they received more mosquito bites, thus balancing their contribution to the infectious reservoir.
Highlights
A detailed understanding of the human infectious reservoir is essential for improving malaria transmission-reducing interventions
We observe that infectiousness is more prevalent in areas with high malaria transmission intensity compared to lowendemic regions, and that children are often more infectious than adults, adults receive more mosquito bites than children, which amplifies their contribution to malaria infections in mosquitoes
Xenodiagnostic surveys were performed in four areas selected to represent three different malaria endemicities (Table 1): in Burkina Faso, the villages of Laye and Balonghin, sampled during the low intensity season of 2013 and the peak intensity season of 2014 respectively, are both characterised by intense seasonal transmission; malaria transmission in Mbita, Kenya, is seasonal with moderate intensity; in Kilifi, located in Kenya, low transmission occurs throughout the year but is higher during the wet season months
Summary
A detailed understanding of the human infectious reservoir is essential for improving malaria transmission-reducing interventions.
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