A biologic basis for integrated malaria control.

Abstract

Abstract. In a series of models of Plasmodium falciparum dynamics, spontaneous local extinctions of the parasite sometimes occurred under steady, perennial-transmission conditions. These extinctions occurred only with extremely low mosquito densities or when the parameter describing the duration of human infection-blocking immunity was at its maximum value, and, simultaneously, those describing vector survivorship and the duration of human infectivity were at their minimum values. The range and frequency of extinctions increased with seasonal transmission, and decreased with the emergence of recombinant genotypes. Here we extend the immunity parameter up to levels that would describe a successful vaccine, and examine the combined influences of seasonality, genotype cross-reactivity, meiotic recombination, and human population turnover on parasite persistence. As Ross did 90 years ago, we conclude that malaria control programs that encompass several methods and targets of intervention are the most likely to succeed. Success is more likely if programs are cognizant of local circumstances of transmission, and, within that context, aim to reduce vector survivorship and human infectivity as well as augment human immunity.

Interrupting Malaria Transmission: Quantifying the Impact of Interventions in Regions of Low to Moderate Transmission

“…Our results for the generalized communities demonstrate that interruption of P. falciparum transmission for at least 150 days using currently available tools is possible in both low and moderate transmission settings, supporting the results of previous studies [8], [16], [37]. As expected, the likelihood of interrupted transmission decreased with increasing EIR, while the time required increased.…”

Mathematical Models of Within-Host and Transmission Dynamics to Determine Effects of Malaria Interventions in a Variety of Transmission Settings

“…As a result, interpretations of model outputs were more measured and cautious. Recent models for strategy evaluation have focused on local vector dynamics30,31 and integrated vector control,9,24,25 anti-malarial drugs,15,32–34 MDA, mass screen-and-treat, and new modes of drug distribution such as intermittent preventative treatment,35 potential vaccines,20,36–38 and integrated intervention strategies that use tools from multiple categories 23,24,39,40. Mathematical models can also help explore the potential impact of new tools proposed or under development.…”

Malaria parasite diversity and transmission intensity affect development of parasitological immunity in a mathematical model

“…Mathematical modelling of malaria made major leaps forward through the Garki Project and the model built to study it [22], as well as modern models for population dynamics which followed [23-27]. In addition to population-level models, recent research has advanced the state of detailed models of the within-host dynamics of Plasmodium falciparum [28-30].…”