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Journal of Parasitology Research
Volume 2012, Article ID 921715, 8 pages
http://dx.doi.org/10.1155/2012/921715
Research Article

Modeling the Effects of Relapse in the Transmission Dynamics of Malaria Parasites

1Instituto Gulbenkian de Ciência, 2781-901 Oeiras, Portugal
2Department of Parasitology, Institute for Biomedical Sciences, University of São Paulo, 05508-000 São Paulo, SP, Brazil

Received 1 May 2011; Revised 12 July 2011; Accepted 20 July 2011

Academic Editor: Mauricio M. Rodrigues

Copyright © 2012 Ricardo Águas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Often regarded as “benign,” Plasmodium vivax infections lay in the shadows of the much more virulent P. falciparum infections. However, about 1.98 billion people are at risk of both parasites worldwide, stressing the need to understand the epidemiology of Plasmodium vivax, particularly under the scope of decreasing P. falciparum prevalence and ecological interactions between both species. Two epidemiological observations put the dynamics of both species into perspective: (1) ACT campaigns have had a greater impact on P. falciparum prevalence. (2) Complete clinical immunity is attained at younger ages for P. vivax, under similar infection rates. We systematically compared two mathematical models of transmission for both Plasmodium species. Simulations suggest that an ACT therapy combined with a hypnozoite killing drug would eliminate both species. However, P. vivax elimination is predicted to be unstable. Differences in age profiles of clinical malaria can be explained solely by P. vivax's ability to relapse, which accelerates the acquisition of clinical immunity and serves as an immunity boosting mechanism. P. vivax transmission can subsist in areas of low mosquito abundance and is robust to drug administration initiatives due to relapse, making it an inconvenient and cumbersome, yet less lethal alternative to P. falciparum.