title: Density-dependent blood stage Plasmodium falciparum suppresses malaria super-infection in a malaria holoendemic population.
abstract: Recent studies of Plasmodium berghei malaria in mice show that high blood-stage parasitemia levels inhibit the development of subsequent liver-stage infections. Whether a similar inhibitory effect on liver-stage Plasmodium falciparum by blood-stage infection occurs in humans is unknown. We have analyzed data from a treatment-time-to-infection cohort of children < 10 years of age residing in a malaria holoendemic area of Kenya where people experience a new blood-stage infection approximately every 2 weeks. We hypothesized that if high parasitemia blocked the liver stage, then high levels of parasitemia should be followed by a "skipped" peak of parasitemia. Statistical analysis of "natural infection" field data and stochastic simulation of infection dynamics show that the data are consistent with high P. falciparum parasitemia inhibiting liver-stage parasite development in humans.
authors.affiliation: Centre for Vascular Research, University of New South Wales, Sydney, NSW, Australia; Kenya Medical Research Institute, Kisumu, Kenya; Case Western Reserve University, Cleveland, Ohio; University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Mykola
authors.initials: M
authors.lastname: Pinkevych
authors.forename: Janka
authors.initials: J
authors.lastname: Petravic
authors.forename: Kiprotich
authors.initials: K
authors.lastname: Chelimo
authors.forename: John
authors.initials: J
authors.lastname: Vulule
authors.forename: James W
authors.initials: JW
authors.lastname: Kazura
authors.forename: Ann M
authors.initials: AM
authors.lastname: Moormann
authors.forename: Miles P
authors.initials: MP
authors.lastname: Davenport
mesh_terms: D000818:Animals; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D004912:Erythrocytes / Q000469:parasitology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008018:Life Cycle Stages / Q000502:physiology*; D008099:Liver / Q000469:parasitology*; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology*; D015233:Models, Statistical; D010963:Plasmodium falciparum / Q000502:physiology*; D011157:Population Dynamics
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