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These new data suggest the potential limited utility of RDTs for monitoring disease or parasite prevalence in some elimination settings. However, AZD6738 parasite densities associated with asymptomatic infections are not static, and may need to be periodically monitored to determine whether RDT use remains appropriate. Malaria Indicator Surveys (MISs) may provide a useful means of monitoring low-density infection prevalence among symptomatic and asymptomatic children. The proportion of low-density P.?falciparum infections (CASK from 71.7% to 100% (data not shown). The specificity remained over 90% in all surveys except for that in Mozambque (74.6%). Higher parasite prevalence and recently treated infections may have led to a higher proportion of false-positive RDT results because of ongoing HRP2 circulation reducing specificity in Mozambique. The parasite prevalence measured by RDTs was consistently higher than that measured by microscopy in all four surveys, which may represent continued HRP2 antigenaemia following treatment, submicroscopic infection, or human error in labelling, interpreting or recording test results. The Roll Back Malaria Monitoring and Evaluation Reference Group is considering recommending the use of RDTs alone for future MISs, which could limit the ability to monitor parasite density, and gametocytaemia, and will have VX-809 price unknown effects on the monitoring of P.?ovale and P.?malariae infections. Studies of the pyrogenic threshold for P.?falciparum malaria in immunona?ve individuals have demonstrated a wide spectrum of parasitaemias at fever onset, ranging from 10 to 200?000?parasites/��L [54]. Data from several malaria-endemic countries indicate that the proportion of low-density (