A MODEL FOR NATURAL IMMUNITY TO ASEXUAL BLOOD STAGES OF PLASMODIUM FALCIPARUM MALARIA IN ENDEMIC AREAS

NICOLAS MAIRE Swiss Tropical Institute, Basel, Switzerland; Navrongo Health Research Centre, Navrongo, Ghana; University of Tübingen, Tübingen, Germany; World Health Organization, Geneva, Switzerland

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THOMAS SMITH Swiss Tropical Institute, Basel, Switzerland; Navrongo Health Research Centre, Navrongo, Ghana; University of Tübingen, Tübingen, Germany; World Health Organization, Geneva, Switzerland

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AMANDA ROSS Swiss Tropical Institute, Basel, Switzerland; Navrongo Health Research Centre, Navrongo, Ghana; University of Tübingen, Tübingen, Germany; World Health Organization, Geneva, Switzerland

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SETH OWUSU-AGYEI Swiss Tropical Institute, Basel, Switzerland; Navrongo Health Research Centre, Navrongo, Ghana; University of Tübingen, Tübingen, Germany; World Health Organization, Geneva, Switzerland

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KLAUS DIETZ Swiss Tropical Institute, Basel, Switzerland; Navrongo Health Research Centre, Navrongo, Ghana; University of Tübingen, Tübingen, Germany; World Health Organization, Geneva, Switzerland

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LOUIS MOLINEAUX Swiss Tropical Institute, Basel, Switzerland; Navrongo Health Research Centre, Navrongo, Ghana; University of Tübingen, Tübingen, Germany; World Health Organization, Geneva, Switzerland

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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.

Author Notes

Reprint requests: Thomas Smith, Swiss Tropical Institute, Socinstrasse 57, PO Box, CH-4002, Basel, Switzerland. E-mail: Thomas-A.Smith@unibas.ch.
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