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Most mathematical models for acquired immunity to Plasmodium falciparum consider effects of immunity on duration of infection and infectiousness, but do not consider the most evident effect of immunity, which is to reduce parasite densities. Few attempts have been made to fit such models to field data. We propose a stochastic simulation model to predict the distributions of P. falciparum parasite densities in endemic areas, in which acquired immunity acts by reducing parasite densities. We have fitted this model to age-specific prevalence and geometric mean densities from settings in Ghana, Nigeria, and Tanzania. The model appears to reproduce reasonably well the parasitologic patterns seen in malariologic surveys in endemic areas and is appropriate for predicting the impact of interventions such as vaccination in the context of continual exposure to P. falciparum.
Received September 18, 2005. Accepted for publication February 7, 2006.
Acknowledgments: We thank Dan Anderegg for editorial assistance and Paulette Rosé for assistance in retrieving the Garki data. We also thank the members of the Technical Advisory Group (Michael Alpers, Paul Coleman, David Evans, Brian Greenwood, Carol Levin, Kevin Marsh, F. Ellis McKenzie, Mark Miller, and Brian Sharp), the Project Management Team at the Program for Appropriate Technology in Health (PATH) Malaria Vaccine Initiative, and GlaxoSmith-Kline Biologicals S.A for their assistance.
Financial support: The mathematical modeling study was supported by the PATH Malaria Vaccine Initiative and GlaxoSmithKline Biologicals S.A.
Disclaimer: Publication of this report and the contents hereof do not necessarily reflect the endorsement, opinion, or viewpoints of the PATH Malaria Vaccine Initiative or GlaxoSmithKline Biologicals S.A.
* Address correspondence to Thomas Smith, Swiss Tropical Institute, Socinstrasse 57, PO Box, CH-4002, Basel, Switzerland. E-mail: nicolas.maire{at}unibas.ch, Thomas-A.Smith{at}unibas.ch
Authors’ addresses: Nicolas Maire, Thomas Smith, and Amanda Ross, Swiss Tropical Institute, Socinstrasse 57, PO Box, CH-4002, Basel, Switzerland, Telephone: 41-61-284-8273, Fax: 41-61-284-8105, E-mails: nicolas.maire{at}unibas.ch, Thomas-A.Smith{at}unibas.ch, and amanda.ross{at}unibas.ch. Seth Owusu-Agyei, Navrongo Health Research Center, Ministry of Health, Navrongo Upper East Region, Ghana. Klaus Dietz, Department of Medical Biometry, University of Tübingen, Westbahnhofstrasse 55, 72070 Tübingen, Germany, Telephone: 49-7071-29-78253, Fax: 49-7071-29-5075. E-mail: klaus.dietz{at}uni-tuebingen.de. Louis Molineaux, Peney-Dessus, CH-1242 Satigny, Geneva, Switzerland.
Reprint requests: Thomas Smith, Swiss Tropical Institute, Socinstrasse 57, PO Box, CH-4002, Basel, Switzerland. E-mail: Thomas-A.Smith{at}unibas.ch.
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