# Quantifying the potential contribution of asymptomatic screening and treatment to malaria control and elimination

> **NIH NIH F31** · NORTHWESTERN UNIVERSITY · 2022 · $46,752

## Abstract

PROJECT SUMMARY
 Malaria continues to be a major global health concern and is responsible for more than 400,000 deaths
annually with more than 90% in Sub-Saharan Africa. Symptoms of malaria are caused by asexual parasites,
but malaria is passed from humans to mosquitoes by sexually-differentiated gametocytes. After repeat
exposures, acquired immunity limits the density of asexual parasites and the likelihood of developing
symptoms. One possible barrier to malaria elimination is the reservoir of chronic infections with asexual
parasite densities too low to prompt treatment, but sufficient gametocytes to infect mosquitoes. Therefore,
detecting and treating asymptomatic infections could reduce transmission and indirectly prevent deaths.
 Preliminary results from a clinical trial in Burkina Faso (the INDIE trial) suggest that regular screening,
testing, and treatment (STT) interventions significantly reduce gametocyte density and infectivity to
mosquitoes. However, the effect of STT on reducing transmission and preventing cases and deaths at the
population level remains unknown. I propose to use agent-based modeling to predict the impact of STT if it
were to be widely implemented as part of malaria control or elimination efforts.
 First, I will use data from INDIE to build a detailed spatial model of the study site, calibrate within-host
relationships between parasites, gametocytes, and infectivity, and validate the effect of STT on gametocyte
density and infectivity. Next, I will predict the impact of implementing universal STT for the entire INDIE
study area on reducing malaria cases. Since STT is resource-intensive, I will compare the effectiveness of
implementing targeted STT in the INDIE study area, considering targeting by age group, limiting STT to the
wet or dry season, and targeting STT to households with the highest mosquito exposure. Using an
archetypes approach and without considering other malaria interventions, I will make a back-of-the-envelope
prediction of the impact of universal and targeted STT across all malaria-endemic Sub-Saharan Africa.
Finally, I will adapt existing models contextualized by intervention history to assess the impact and cost-
effectiveness of targeted STT strategies in high-burden and near-elimination settings, compared to
established interventions. The results of the proposed research will help policymakers decide if, when, and
how to deploy STT to combat malaria.
 The F31 Ruth L. Kirschstein NRSA Individual Predoctoral Fellowship award will allow me to build my
quantitative and research skills, improve my scientific writing and communication, and gain expertise in
infectious disease epidemiology on the path toward becoming a successful independent investigator. In
conducting the proposed research, I will integrate into a global network of malaria modelers and
epidemiologists, gain familiarity with agent-based modeling, and make scientific contributions to the
assessment of STT as a tool for malaria control an...

## Key facts

- **NIH application ID:** 10537580
- **Project number:** 1F31AI172387-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Tobias Holden
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $46,752
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10537580

## Citation

> US National Institutes of Health, RePORTER application 10537580, Quantifying the potential contribution of asymptomatic screening and treatment to malaria control and elimination (1F31AI172387-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10537580. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*