Uncovering silent malaria reservoirs in Southern Ethiopia: community-based molecular detection of asymptomatic and sub-microscopic infections and their implications for diagnosis and control

Asymptomatic and submicroscopic Plasmodium infections, prevalent yet undetected by microscopy and RDTs, were reliably identified by qPCR, revealing substantial underestimation of true prevalence and a persistent transmission reservoir that challenges malaria control. These results underscore the limitations of symptom-based strategies and the need for sensitive diagnostics to enhance surveillance of low-density infections.