A Malaria Transmission Model Predicts Holoendemic, Hyperendemic, and Hypoendemic Transmission Patterns Under Varied...

A model is developed of malaria (Plasmodium falciparum) transmission in vector (Anopheles gambiae) and human populations that include the capacity for both clinical and parasite suppressing immunity. This model is coupled with a population model for Anopheles gambiae that varies seasonal with temperature and larval habitat availability. At steady state, the model clearly distinguishes uns hypoendemic transmission patterns from stable hyperendemic and holoendemic patterns of transmission. The model further distinguishes hyperendemic from holoendemic disease based on seasonality of infection. For hyperendemic and holoendemic transmission, the model produces the relationship between entomological inoculation rate and disease prevalence observed in the field. It further produces expected rates of immunity and prevalence across all three endemic patterns. The model does not produce mesoendemic transmission patterns at steady state for any parameter choices, leading to the conclusion that mesoendemic patterns occur during transient states or as a result of factors not included in this study. The model shows that coupling the effect of varying larval habitat availability with the effects of clinical and parasite-suppressing immunity is enough to produce known patterns of malaria transmission.