Density-dependent blood stage Plasmodium falciparum suppresses malaria super-infection in a malaria holoendemic population

UMMS Affiliation

Department of Pediatrics

Publication Date


Document Type



Animals; Cell Count; Child; Child, Preschool; *Endemic Diseases; Erythrocytes; Humans; Infant; Infant, Newborn; Kenya; Life Cycle Stages; Liver; Malaria, Falciparum; *Models, Statistical; Plasmodium falciparum; Population Dynamics


Immunology and Infectious Disease | Parasitic Diseases | Parasitology | Pediatrics


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.

DOI of Published Version



Am J Trop Med Hyg. 2013 Nov;89(5):850-6. doi: 10.4269/ajtmh.13-0049. Epub 2013 Sep 9. Link to article on publisher's site

Journal/Book/Conference Title

The American journal of tropical medicine and hygiene

Related Resources

Link to Article in PubMed

PubMed ID