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Plasmodium falciparum parasitaemia described by a new mathematical model

Published online by Cambridge University Press:  18 June 2002

L. MOLINEAUX ,
H. H. DIEBNER ,
M. EICHNER ,
W. E. COLLINS ,
G. M. JEFFERY  and
K. DIETZ
L. MOLINEAUX
Affiliation:
World Health Organization (Retired )
H. H. DIEBNER
Affiliation:
Department of Medical Biometry, University of Tübingen, Westbahnhofstrasse 55, D-72070 Tübingen, Germany Center for Art and Media, Lorenzstrasse 19, D-76135 Karlsruhe, Germany
M. EICHNER
Affiliation:
Department of Medical Biometry, University of Tübingen, Westbahnhofstrasse 55, D-72070 Tübingen, Germany
W. E. COLLINS
Affiliation:
Centers for Disease Control and Prevention, US Public Health Service, Department of Health and Human Services, Atlanta, GA, USA
G. M. JEFFERY
Affiliation:
U.S. Public Health Service (Retired )
K. DIETZ
Affiliation:
Department of Medical Biometry, University of Tübingen, Westbahnhofstrasse 55, D-72070 Tübingen, Germany
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Abstract

A new mathematical model of Plasmodium falciparum asexual parasitaemia is formulated and fitted to 35 malaria therapy cases making a spontaneous recovery after primary inoculation. Observed and simulated case-histories are compared with respect to 9 descriptive statistics. The simulated courses of parasitaemia are more realistic than any previously published. The model uses a discrete time-step of 2 days. Its realistic behaviour was achieved by the following combination of features (i) intra-clonal antigenic variation, (ii) large variations of the variants' baseline growth rate, depending on both variant and case, (iii) innate autoregulation of the asexual parasite density, variable among cases, (iv) acquired variant-specific immunity and (v) acquired variant-transcending immunity, variable among cases. Aspects of the model's internal behaviour, concerning variant dynamics, as well as the respective contributions of the three control mechanisms (iii) – (v), are displayed. Some implications for pathogenesis and control are discussed.

Keywords

Plasmodium falciparummathematical modelmalaria therapyPfEMP1
Type
Research Article
Information
Parasitology , Volume 122 , Issue 4 , April 2001 , pp. 379 - 391
Copyright
© 2001 Cambridge University Press

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