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According to the World Malaria Report 2019, there has been a reduction in malaria cases worldwide by approximately 23 million during 2010–18 (ref. 1). However, data does not suggest a significant case reduction from 2017 to 2018 globally. India, interestingly, showed a reduction of 2.6 million malaria cases in 2018 compared to 2017 (ref. 1). This is encouraging since most other high-burden African countries reported an increase in disease burden. As India moves towards its goal of malaria elimination by 2030, the focus has shifted to controlling hidden and underexplored niches of infection such as asymptomatic and sub- microscopic malaria. Studies conducted across different epidemiological settings in India over the past few years roughly peg the asymptomatic malaria burden anywhere between 18% and 71% (ref. 2). Identification of these cases, accurate diagnosis and evaluation of their actual role in persistence and transmission of the malaria parasite present unique challenges.
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