02090nas a2200373   4500000000100000008004100001260001200042653001200054653001800066653004000084653001500124653001900139653001700158100001200175700001200187700001500199700001400214700001500228700001500243700001300258700001400271700001300285700001300298700001400311700001800325700001300343700001300356700001500369700001200384245010800396856007300504520112500577022001401702       2020                            d  c03/202010aMalaria10aLeishmaniasis10aHuman African Trypanosomiasis (HAT)10aFiliriasis10aChagas disease10aasymptomatic1 aAlvar J1 aAlves F1 aBucheton B1 aBurrows L1 aBüscher P1 aCarrillo E1 aFelger I1 aHübner M1 aMoreno J1 aPinazo M1 aRibeiro I1 aSosa-Estani S1 aSpecht S1 aTarral A1 aWourgaft N1 aBilbe G00aImplications of asymptomatic infection for the natural history of selected parasitic tropical diseases.  uhttps://link.springer.com/content/pdf/10.1007/s00281-020-00796-y.pdf3 a<p>Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asymptomatic carriers are a common element that may promote resurgence; their impact in terms of proportion in the population and role in transmission needs to be determined. In this paper, we review the current evidence on whether or not to treat asymptomatic carriers given the relevance of their role in the transmission of a specific disease, the efficacy and toxicity of existing drugs, the Public Health interest, and the benefit at an individual level, for example, in Chagas disease, to prevent irreversible organ damage. In the absence of other control tools such as vaccines, there is a need for safer drugs with good risk/benefit profiles in order to change the paradigm so that it addresses the complete infectious process beyond manifest disease to include treatment of non-symptomatic infected persons.</p>  a1863-2300