Research Article Large Variations in Malaria Parasite Carriage by Afebrile School Children Living in Nearby Communities in the Central Region of Ghana Evans K. Obboh, 1 Ruth E. Okonu, 2 and Linda E. Amoah 2,3 1 Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana 2 Immunology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana 3 West Africa Center for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana Correspondence should be addressed to Linda E. Amoah; lamoah@noguchi.ug.edu.gh Received 26 March 2020; Revised 25 June 2020; Accepted 3 September 2020; Published 22 September 2020 Academic Editor: Aditya Prasad Dash Copyright © 2020 Evans K. Obboh et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Indicators of successful malaria control interventions include a reduction in the prevalence and densities of malaria parasites contained in both symptomatic and asymptomatic infections as well as a reduction in malaria transmission. Individuals harboring malaria parasites in asymptomatic infections serve as reservoirs for malaria transmission. is study determined the prevalence of asymptomatic malaria parasite carriage in afebrile children attending six different schools in two districts, the Cape Coast Metropolitan Assembly (CCMA) and the Komenda Edina Eguafo Abirem (KEEA) of the Central Region of Ghana. Methods. is cross sectional study recruited afebrile children aged between 3 and 15 years old from six randomly selected schools in the Central Region of Ghana. Finger-pricked blood was collected and used to prepare thick and thin blood smears as well as spot a strip of filter paper (Whatman #3). Nested PCR was used to identify Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax in DNA extracted from the filter paper spots. e multiplicity of P. falciparum infection was determined using merozoite surface protein 2 genotyping. Results. Out of the 528 children sampled, PCR identified 27.1% to harbor Plasmodium parasites in asymptomatic infections, whilst microscopy identified malaria parasites in 10.6% of the children. e overall PCR estimated prevalence of P. falciparum and P. malariae was 26.6% and 1.3%, respectively, with no P. ovale or P. vivax identified by PCR or microscopy. e RDTpositivity rate ranged from 55.8% in Simiw to 4.5% in Kuful. Children from the Simiw Basic School accounted for 87.5% of all the asymptomatic infections. e multiplicity of P. falciparum infection was predominantly monoclonal and biclonal. Conclusions. e low prevalence of asymptomatic malaria parasite carriage by the children living in the Cape Coast Metropolis suggests that the malaria control interventions in place in CCMA are highly effective and that additional malaria control interventions are required for the KEEA district to reduce the prevalence of asymptomatic malaria parasite carriers. No molecular evidence of P. ovale and P. vivax was identified in the afebrile children sampled from the selected schools. 1. Background Asymptomatic Plasmodium parasite carriage is a dire set- back to malaria control and elimination efforts, particularly as they serve as potential reservoirs for malaria transmission [1]. Microscopy, the gold standard technique employed in most malaria-endemic settings for the diagnosis of malaria [2], has a technical detection limit (LoD), which is defined as the lowest number of parasites/μl of blood at which parasites in a blood smear would be detected [3] of between 5 and 10 parasites/μl of blood [4] but a more practical LoD of between 40 and 100 parasites/μl [5]. e wide range observed in the LoD stems mainly from the level of expertise of the mi- croscopist [4, 5]. Majority of asymptomatic malaria infec- tions however are at submicroscopic densities, failing detection by microscopy, making microscopy an inappro- priate tool to use for the identification of malaria parasites contained in asymptomatic infections. Although Plasmodium falciparum (P. falciparum) is the predominant Plasmodium species in the World Health Hindawi Journal of Tropical Medicine Volume 2020, Article ID 4125109, 10 pages https://doi.org/10.1155/2020/4125109