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

<div>Bifurcation diagrams showing competitive exclusion (a) and coexistence equilibrium (b) for the drug-sensitive and drug-resistant <i>P. falciparum</i> parasite strains under different values of threshold quantities <svg height="11.9087pt" id="M397" style="vertical-align:-3.2728pt" version="1.1" viewbox="-0.0498162 -8.6359 12.0663 11.9087" width="12.0663pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M610 18C585 26 567 34 540 68C517 97 499 128 476 171C452 215 425 276 413 304C496 332 570 394 570 494C570 555 545 595 509 619S419 650 364 650H139L133 622C216 615 219 612 203 527L129 132C112 40 105 36 23 28L17 0H279L285 28C199 34 194 40 211 132L239 284H284C320 284 334 275 351 236C374 182 394 140 420 93C459 23 495 -1 592 -8H600L610 18ZM480 485C480 424 449 372 403 342C374 323 338 316 293 316H245L291 562C296 589 301 601 311 608S337 618 358 618C432 618 480 575 480 485Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,8.086,3.132)"><path d="M319 325C317 349 306 409 297 431C277 440 250 449 209 449C117 449 57 389 57 319C57 243 122 209 182 182C232 159 261 135 261 91C261 48 227 21 190 21C130 21 85 79 68 145L41 140C41 104 51 36 58 22C75 7 121 -12 172 -12C252 -12 337 35 337 126C337 195 286 231 210 262C166 281 126 304 126 348C126 388 152 417 191 417C240 417 274 378 294 318L319 325Z"></path></g></svg> and <span class="nowrap"><svg height="11.8174pt" id="M398" style="vertical-align:-3.1815pt" version="1.1" viewbox="-0.0498162 -8.6359 12.1028 11.8174" width="12.1028pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M610 18C585 26 567 34 540 68C517 97 499 128 476 171C452 215 425 276 413 304C496 332 570 394 570 494C570 555 545 595 509 619S419 650 364 650H139L133 622C216 615 219 612 203 527L129 132C112 40 105 36 23 28L17 0H279L285 28C199 34 194 40 211 132L239 284H284C320 284 334 275 351 236C374 182 394 140 420 93C459 23 495 -1 592 -8H600L610 18ZM480 485C480 424 449 372 403 342C374 323 338 316 293 316H245L291 562C296 589 301 601 311 608S337 618 358 618C432 618 480 575 480 485Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,8.086,3.132)"><path d="M181 342V451C133 431 89 419 40 411V388C98 381 102 377 102 311V104C102 38 95 32 33 26V0H263V26C186 32 181 38 181 104V287C203 343 235 372 261 372C277 372 289 366 304 352C310 346 318 345 330 350C349 359 362 379 362 399C362 422 338 449 304 449C256 449 213 393 183 342H181Z"></path></g></svg>.</span> Both parasite strains coexists when <svg height="11.927pt" id="M399" style="vertical-align:-3.291101pt" version="1.1" viewbox="-0.0498162 -8.6359 33.3809 11.927" width="33.3809pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M610 18C585 26 567 34 540 68C517 97 499 128 476 171C452 215 425 276 413 304C496 332 570 394 570 494C570 555 545 595 509 619S419 650 364 650H139L133 622C216 615 219 612 203 527L129 132C112 40 105 36 23 28L17 0H279L285 28C199 34 194 40 211 132L239 284H284C320 284 334 275 351 236C374 182 394 140 420 93C459 23 495 -1 592 -8H600L610 18ZM480 485C480 424 449 372 403 342C374 323 338 316 293 316H245L291 562C296 589 301 601 311 608S337 618 358 618C432 618 480 575 480 485Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,8.086,3.132)"><path d="M357 391C357 416 325 451 270 451C241 451 179 431 146 400C109 365 97 334 97 307C97 248 143 213 196 180C250 146 261 123 261 101C261 75 237 40 190 40C153 40 110 72 86 109C81 116 68 119 55 112C37 102 24 87 24 66C24 30 85 -12 137 -12C229 -12 331 62 331 140C331 189 304 218 236 260C197 284 164 309 164 346C164 381 194 400 220 400C259 400 282 380 304 350C310 342 321 339 330 344C347 353 357 372 357 391Z"></path></g><g transform="matrix(.013,0,0,-0.013,15.696,0)"><path d="M512 230V281L75 514V456L453 256V254L75 55V-3L512 230Z"></path></g><g transform="matrix(.013,0,0,-0.013,26.959,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"></path></g></svg> and <svg height="11.8174pt" id="M400" style="vertical-align:-3.1815pt" version="1.1" viewbox="-0.0498162 -8.6359 33.2896 11.8174" width="33.2896pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M610 18C585 26 567 34 540 68C517 97 499 128 476 171C452 215 425 276 413 304C496 332 570 394 570 494C570 555 545 595 509 619S419 650 364 650H139L133 622C216 615 219 612 203 527L129 132C112 40 105 36 23 28L17 0H279L285 28C199 34 194 40 211 132L239 284H284C320 284 334 275 351 236C374 182 394 140 420 93C459 23 495 -1 592 -8H600L610 18ZM480 485C480 424 449 372 403 342C374 323 338 316 293 316H245L291 562C296 589 301 601 311 608S337 618 358 618C432 618 480 575 480 485Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,8.086,3.132)"><path d="M181 342V451C133 431 89 419 40 411V388C98 381 102 377 102 311V104C102 38 95 32 33 26V0H263V26C186 32 181 38 181 104V287C203 343 235 372 261 372C277 372 289 366 304 352C310 346 318 345 330 350C349 359 362 379 362 399C362 422 338 449 304 449C256 449 213 393 183 342H181Z"></path></g><g transform="matrix(.013,0,0,-0.013,15.605,0)"><path d="M512 230V281L75 514V456L453 256V254L75 55V-3L512 230Z"></path></g><g transform="matrix(.013,0,0,-0.013,26.868,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"></path></g></svg> (see part (b)).</div>

Computational and Mathematical Methods in Medicine

fig6

Figure 6

Figure 6: Multiple-Strain Malaria Infection and Its Impacts on <i>Plasmodium falciparum</i> Resistance to Antimalarial Therapy: A Mathematical Modelling Perspective 

Figure 6 | Multiple-Strain Malaria Infection and Its Impacts on Plasmodium falciparum Resistance to Antimalarial Therapy: A Mathematical Modelling Perspective 