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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new mathematical model of malaria has been developed for comparing the effects of alternative control measures. It describes both the temporal changes of the P. falciparum infection rate and the immunity level of the population as a function of the dynamics and characteristics of the vector populations, which are summarized in the concept of vectorial capacity. A critical vectorial capacity is specified, below which malaria cannot maintain itself at an endemic level. The model has been tested with epidemiological data collected in a WHO research project in the African Savannah, Kano State, Northern Nigeria, since October 1970. The estimates of the model parameters were obtained by minimizing the chi(2) function that measures the discrepancy between the observed and expected age-specific parasite rates in the two villages with the highest and the lowest vectorial capacity, respectively, at five surveys during one year of baseline data collection and between the observed and expected infant inoculation rates, in the main transmission seasons, in the same two villages. The model describes three aspects of immunity: loss of infectivity, loss of detectability, and increase of recovery rate. It is assumed that loss of infectivity precedes loss of detectability and increase of recovery rate. Superinfections are slowing down the recovery for high inoculation rates but do not reduce them to zero. They do not increase infectivity.
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PMID:A malaria model tested in the African savannah. 461 12

In regions of high rates of malaria transmission, mosquitoes repeatedly transmit liver-tropic Plasmodium sporozoites to individuals who already have blood-stage parasitemia. This manifests itself in semi-immune children (who have been exposed since birth to Plasmodium infection and as such show low levels of peripheral parasitemia but can still be infected) older than 5 years of age by concurrent carriage of different parasite genotypes at low asymptomatic parasitemias. Superinfection presents an increased risk of hyperparasitemia and death in less immune individuals but counterintuitively is not frequently observed in the young. Here we show in a mouse model that ongoing blood-stage infections, above a minimum threshold, impair the growth of subsequently inoculated sporozoites such that they become growth arrested in liver hepatocytes and fail to develop into blood-stage parasites. Inhibition of the liver-stage infection is mediated by the host iron regulatory hormone hepcidin, whose synthesis we found to be stimulated by blood-stage parasites in a density-dependent manner. We mathematically modeled this phenomenon and show how density-dependent protection against liver-stage malaria can shape the epidemiological patterns of age-related risk and the complexity of malaria infections seen in young children. The interaction between these two Plasmodium stages and host iron metabolism has relevance for the global efforts to reduce malaria transmission and for evaluation of iron supplementation programs in malaria-endemic regions.
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PMID:Host-mediated regulation of superinfection in malaria. 2206 6