The emergence and spread of artemisinin-resistant Plasmodium falciparum in the Greater Mekong subregion, followed by the failure of artemisinin combination therapies (ACTs) presents a serious and imminent threat to the region and beyond.1, 2, 3, 4 The countries in the Greater Mekong subregion are committed to malaria elimination in the near future,5 provided the available tools remain effective.

Among the many factors required for malaria elimination, effective vector control (eg, long-lasting insecticidal nets) and access to effective community-based early diagnosis and treatment stand out as essential6, 7 but these two interventions are not sufficient everywhere. In the Greater Mekong subregion, long-lasting insecticidal nets provide incomplete protection because of the biting behaviour of anopheline vectors,8, 9 and early diagnosis and treatment does not address the problem of asymptomatic parasite carriers who are an important and increasingly reported source of malaria in low transmission areas.10, 11, 12, 13 The treatment of asymptomatic carriers could therefore be important to accelerate the elimination of malaria. The poor sensitivity of point-of-care tests limits the use of active screening and treatment approaches to….. continue reading