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Dryad

Heterogeneous mosquito exposure increases Plasmodium vivax and Plasmodium falciparum coinfections: a modelling study

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Oct 24, 2024 version files 13.54 KB

Abstract

In malaria-endemic regions, Plasmodium vivax and Plasmodium falciparum coexist and may interact. For instance, fevers induced by P. falciparum might activate dormant P. vivax parasites and concurrent radical cure of both species has been proposed to prevent relapses. Heterogeneous mosquito exposure may contribute to the dependence of both parasites. We conducted a literature review on their respective prevalence and that of coinfections. The data revealed a positive correlation between P. vivax and P. falciparum prevalence and coinfection prevalences exceeding expectations assuming infections occur independently. We used the review data to fit a compartmental model of coinfections that features heterogeneous mosquito exposure. The fit suggests that heterogeneous exposure sufficiently explains the observed departure from independence. Finally, we performed simulations under the model assessing the impact on P. vivax prevalence of the activation-by-fever hypothesis and the radical cure proposition. We demonstrated a moderate impact of allowing P. falciparum fevers to reactivate P. vivax and a substantial impact of treating P. falciparum cases with radical cure. Our model highlights the dependence between P. falciparum and P. vivax and emphasises the influence of heterogeneous mosquito exposure. This simple framework can inform the design of more complex models assessing integrated malaria control strategies in co-endemic regions.