Hidden reservoirs of infection: prevalence and risk factors of asymptomatic malaria in a high-endemic region of Zambia

Abstract Background Malaria remains a significant global health challenge, particularly in sub-Saharan Africa (SSA), where asymptomatic cases contribute to ongoing transmission and hinder elimination efforts. Asymptomatic individuals act as hidden reservoirs, sustaining onward malaria transmission. This study aimed to determine the prevalence and risk factors of asymptomatic malaria in Mwandi District, Zambia. Methods A cross-sectional study was conducted between January to May 2024 in Mwandi District. Blood samples were collected for malaria diagnosis and simultaneously tested using rapid diagnostic tests and Giemsa-stained blood smear microscopy techniques to detect Plasmodium infections. Structured questionnaires were administered to gather demographic data and information on potential risk factors. Descriptive statistics were used to summarize the data while categorical variables were compared using the chi-square test or Fisher’s exact test. Logistic regression was used to assess associations between outcomes and independent variables, with statistical significance set at p