Reduction in Asymptomatic falciparum malaria infection amongst schoolchildren in three ecological zones of Ghana between 2017 and 2023

Despite the implementation of intervention measures, eliminating malaria in Ghana remains challenging due to the presence of a significant number of asymptomatic malaria-infected individuals. This study aimed to determine the temporal dynamics and spatial distribution of asymptomatic malaria amongst schoolchildren, by comparing infection from a cross-sectional study conducted in 2023 with a previously published data in 2017 in the same sites in Ghana. Schoolchildren were screened using microscopy and PCR for malaria infection during the dry and rainy seasons in 2023 (1,154 participants) and compared with data from 2017 (1,109 participants). Asymptomatic P. falciparum infection by microscopy decreased from 16.05 in 2017 to 1.21% in 2023, and by PCR from 39.95% in 2017 to 17.33% in 2023. Infection rates in the Sahel zone decreased significantly by 60% in 2023 compared to 2017. Submicroscopic infections were higher in 2017 (24.35%) than 2023 (16.46%), with the forest zone having the highest submicroscopic infections at both timepoints 2017 (47.01%) and 2023 (28.28%). Asymptomatic malaria infections in the schoolchildren decreased between 2017 and 2023. Continuous surveillance and improved interventions are needed to further reduce the parasite carriage, especially among schoolchildren.