Proportion of participants with knowledge of AsM.

IntroductionMalaria is a parasitic disease caused by Plasmodium parasite and transmitted to humans by infected female Anopheles mosquito. Several studies have explored community knowledge of malaria. However, despite the remarkable proportions of asymptomatic malaria, its awareness remains relatively understudied among the affected communities. Hence, this study aimed to determine the proportion of people with knowledge of asymptomatic malaria in endemic countries and describe their perspective towards malaria control interventions. The findings from this study could contribute to developing tailored interventions in both low and high-transmission settings.MethodThe systematic review protocol was deposited in protocols.io and registered at PROSPERO (ID: CRD42024508104). A systematic literature review was conducted searching for peer-reviewed articles on knowledge of asymptomatic malaria published from 2010 to 2024. Three databases (PubMed (MEDLINE), Google Scholar, and Web of Science) were searched. The risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool and the Mixed Methods Appraisal Tool (MMAT). A thematic analysis and a narrative synthesis were conducted to synthesise the results. The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).ResultsIn total, 483 articles were retrieved, and 11 relevant articles were included in the analysis. According to four studies conducted among the general public, the proportion of individuals knowledgeable of asymptomatic malaria ranged from 14.2% to 79.8%. The proportion among health personnel was 88% (one study). The qualitative studies showed varied and lacking knowledge of asymptomatic malaria among the participants, as well as refusal and reluctance to adhere to interventions targeting asymptomatic Plasmodium carriers.ConclusionThis review showed a lack of knowledge of asymptomatic malaria among endemic communities and a remarkable shortage of studies on related topics. For better malaria control and to accelerate disease elimination, education on asymptomatic malaria would be necessary. Given the limited number of studies, further research on knowledge of asymptomatic malaria would be crucial in various malaria-endemic areas to provide evidence for tailored interventions.

引言
疟疾是由疟原虫（Plasmodium parasite）引发的寄生虫病，可经受感染的雌性按蚊（Anopheles mosquito）叮咬传播至人类。已有多项研究探讨了社区人群的疟疾认知水平。然而，尽管无症状疟疾（asymptomatic malaria）的发病占比颇高，但疟疾流行区社区对该病症的认知仍相对缺乏系统性研究。因此，本研究旨在明确疟疾流行国家中知晓无症状疟疾的人群比例，并描述其对疟疾防控干预措施的看法。本研究结果可为高低传播场景下的定制化干预措施开发提供科学参考。

方法
本系统评价（systematic review）方案已上传至protocols.io平台，并在PROSPERO完成注册（注册号：CRD42024508104）。研究检索了2010年至2024年间发表的关于无症状疟疾认知的同行评议论文，检索数据库涵盖PubMed（MEDLINE）、Google Scholar及Web of Science。采用乔安娜·布里格斯研究所（Joanna Briggs Institute, JBI）质量评价工具与混合研究评价工具（Mixed Methods Appraisal Tool, MMAT）对纳入研究的偏倚风险（risk of bias）进行评估。通过主题分析法与叙事性综合分析对研究结果进行整合。本研究严格遵循《系统评价和Meta分析首选报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）规范开展。

结果
本研究共检索到483篇文献，最终纳入11篇相关文献进行分析。针对普通人群开展的4项研究显示，知晓无症状疟疾的个体比例介于14.2%至79.8%之间；针对卫生人员的1项研究显示该认知比例为88%。质性研究结果表明，参与者对无症状疟疾的认知参差不齐且存在明显不足，同时对针对无症状疟原虫携带者的干预措施存在抵触情绪且不愿依从。

结论
本系统评价显示，疟疾流行区社区对无症状疟疾的认知普遍不足，且相关主题的研究数量极为匮乏。为优化疟疾防控策略、加速疾病消除进程，普及无症状疟疾相关知识实属必要。鉴于现有研究数量有限，在各类疟疾流行区开展针对无症状疟疾认知的进一步研究，可为定制化干预措施提供证据支撑，这一点至关重要。