A Model for Estimating Total Parasite Load in Falciparum Malaria Patients

Authors: GRAVENOR M.B.¹; LLOYD A.L.²; KREMSNER P.G.³; MISSINOU M.A.³; ENGLISH M.^{1, 4}; MARSH K.⁴; KWIATKOWSKI D.¹

Source: Journal of Theoretical Biology, Volume 217, Number 2, July 2002 , pp. 137-148(12)

Publisher: Academic Press

Abstract:

We describe an age-structured mathematical model of the malaria parasite life cycle that uses clinical observations of peripheral parasitaemia to estimate population dynamics of sequestered parasites, which are hidden from the clinical investigator. First, the model was tested on parasite populations cultured in vitro, and was found to account for 72% of the variation in that sub-population of parasites that would have been sequestered in vivo. Next, the model was applied to patients undergoing antimalarial therapy. Using individual data sets we found that although the model fitted the peripheral parasite curves very well, unique solutions for the fit could not be obtained; therefore, robust estimates of sequestered parasite dynamics remained unavailable. We conclude that even given detailed data on individual parasitaemia, estimates of sequestered numbers may be difficult to obtain. However, if data on individuals undergoing similar therapy are collected at equal time intervals, some of these problems may be overcome by estimating specific parameters over groups of patients. In this manner we estimated sequestered parasite density in a group of patients sampled at identical time points following antimalarial treatment. Using this approach we found significant relationships between changes in parasite density, age structure and temperature that were not apparent from the analysis of peripheral parasitaemia only. Copyright 2002 Elsevier Science Ltd. All rights reserved.

Language: English

Document Type: Research article

Affiliations: 1: Department of Paediatrics, John Radcliffe Hospital, Oxford, U.K. 2: Institute for Advanced Study, Einstein Drive, Princeton, NJ, 08540, U.S.A. 3: Department of Parasitology, University of Tu¨bingen, Lambare´ne´, Gabon, Germany 4: KEMRI/Wellcome Trust Laboratories, Kilifi, Kenya

Publication date: 2002-07-01

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• By this author: GRAVENOR M.B. ;  LLOYD A.L. ;  KREMSNER P.G. ;  MISSINOU M.A. ;  ENGLISH M. ;  MARSH K. ;  KWIATKOWSKI D.

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