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Background  The gametocyte stage of  Plasmodium falciparum  is considered an important target for disrupting malaria transmission. Indications are that various demographic groups, such as children and pregnant women may differ in risk of harbouring gametocytes, which may be crucial for targeted control. In this study, the relationship between the prevalence and multiplicity of  P. falciparum , asexual parasite infections and gametocytaemia was assessed in three different demographic groups in an area of southern Ghana with low malaria endemicity. Levels of antibody responses to  Pf s230 were also assessed as a proxy for the presence of gametocytes.    Methods  The study involved multiple cross-sectional sampling of children (N = 184, aged 2–15 years), male and non-pregnant female adults (N = 154, aged 16–65 years) and pregnant women (N = 125, aged 18–45 years) from Asutsuare in the Shai Osudoku District of Greater Accra Region in Ghana. Asexual parasitaemia was detected by microscopy and PCR, and gametocytaemia was assessed by  Pf s25-real time PCR. Multiclonal  P. falciparum  infections were estimated by  msp2  genotyping and an indirect ELISA was used to measure plasma IgG antibodies to  Pf s230 antigen.    Results  Overall, children and pregnant women had higher prevalence of submicroscopic gametocytes (39.5% and 29.7%, respectively) compared to adults (17.4%). Multiplicity of infection observed amongst children (3.1) and pregnant women (3.9) were found to be significantly higher (P = 0.006) compared with adults (2.7). Risk of gametocyte carriage was higher in individuals infected with  P. falciparum  having both  Pf msp2 3D7 and FC27 parasite types (OR = 5.92, 95% CI 1.56–22.54, P = 0.009) compared with those infected with only 3D7 or FC27 parasite types. In agreement with the parasite prevalence data, anti- Pfs 230 antibody levels were lower in gametocyte positive adults (β = − 0.57, 95% CI − 0.81, − 0.34, P &lt; 0.001) compared to children.    Conclusions  These findings suggest that children and pregnant women are particularly important as  P. falciparum  submicroscopic gametocyte reservoirs and represent important focus groups for control interventions. The number of clones increased in individuals carrying gametocytes compared to those who did not carry gametocytes. The higher anti-gametocyte antibody levels in children suggests recent exposure and may be a marker of gametocyte carriage.    Electronic supplementary material  The online version of this article (10.1186/s12936-018-2479-y) contains supplementary material, which is available to authorized users.

malaria journal

The prevalence of submicroscopic Plasmodium falciparum gametocyte carriage and multiplicity of infection in children, pregnant women and adults in a low malaria transmission area in Southern Ghana