Mathematical modelling of immunity to malaria

Abstract A comparison of two epidemiological models of immunity to malaria shows that different characterizations of immunity boosted by exposure to infection generate qualitatively different results. Attempts to control disease by reducing transmission or increasing the recovery rate can produce an increase in prevalence in the compartmental model with discrete epidemiological states. However, the parasite density always decreases in response to disease control in the model with continuous epidemiological variables. Each model accounts for some epidemiological patterns. The increase in prevalence seen in the compartmental model is in accord with observed effects of variation in transmission. Parasite suppression in areas of antimalarial drug use is consistent with the effect of an increased recovery rate in the density model. Future work should combine the two approaches, perhaps by using the compartmental model over the low to moderate range of infection rates and switching to the density model at high infection rates. In any case, the validation of models needs to take account of the usage of antimalarial drugs as well as the intensity of transmission.