Multiple-Strain Malaria Infection and Its Impacts on Plasmodium falciparum Resistance to Antimalarial Therapy: A Mathematical Modelling Perspective

Abstract

The emergence of parasite resistance to antimalarial drugs has contributed significantly to global human mortality and morbidity due to malaria infection. The impacts of multiple-strain malarial parasite infection have further generated a lot of scientific interest. In this paper, we demonstrate, using the epidemiological model, the effects of parasite resistance and competition between the strains on the dynamics and control of Plasmodium falciparum malaria. The analysed model has a trivial equilibrium point which is locally asymptotically stable when the parasite’s effective reproduction number is less than unity. Using contour plots, we observed that the efficacy of antimalarial drugs used, the rate of development of resistance, and the rate of infection by merozoites are the most important parameters in the multiple-strain P. falciparum infection and control model. Although the drug-resistant strain is shown to be less fit, the presence of both strains in the human host has a huge impact on the cost and success of antimalarial treatment. To reduce the emergence of resistant strains, it is vital that only effective antimalarial drugs are administered to patients in hospitals, especially in malaria-endemic regions. Our results emphasize the call for regular and strict surveillance on the use and distribution of antimalarial drugs in health facilities in malaria-endemic countries.

Parasite co-infection: an ecological, molecular and experimental perspective

“…In addition to field evaluations and experimental laboratory studies, insight into the dynamics of parasite co-infection benefit from modelling and theoretical approaches. Modelling can assist with the interpretation of spatial/geographical mapping to identify areas of high co-infection risk, as well as determining the strength of interactions between co-infecting parasites in vivo [ 80 , 81 ] and therapeutic impact [ 82 ]. Such data will become increasingly important in future, as climate change and human activities alter parasite and vector distributions, which may increase or reduce opportunities for species to interact.…”

Temporal genomic analysis ofPlasmodium falciparumreveals increased prevalence of mutations associated with delayed clearance following treatment with artemisinin-lumefantrine in Choma District, Southern Province, Zambia

“…Importantly, parasite clearance curves in TES are less informative in African regions where most of infections consist of multiple parasite strains, 9 , 10 meaning that resistant parasites are likely to share their host with sensitive parasites, obscuring detection, particularly early during the spread of resistance. 10 , 11 Molecular surveillance of P. falciparum parasites is a powerful tool for early detection of emergence and monitoring the spread of antimalarial drug resistance for known resistance mutations and genes.…”

A cell-level dynamical model for malaria parasite infection with antimalarial drug treatment

“…In a study by Tabo et al [34], the interaction of the malaria parasite in sexual and asexualual stages during its life cycle, i.e., a combination of hepatocyte stage, erythrocyte stage, and mosquitostage malaria parasite into one mathematical model is studied. The authors also include blood-stage treatment as a control strategy and investigate the effect of the treatment for malaria control within the host.…”

“…The findings indicated the progression of malaria and control of the disease with a treatment strategy that combines very efficient medications against malaria parasites with effective immune responses. The studies [34,36,37] are proposed the in-host dynamics of malaria infection by considering both erythrocyte stage and hepatocyte stage malaria infection. However, to the best of our knowledge, no study has considered the within-host dynamics of malaria parasites with stage-specific antimalarial drug treatment.…”