Determining parameter distribution in within-host severe P. falciparum malaria.

Numerous studies have been carried out on within-host Plasmodium falciparum malaria with varying results. Some studies have suggested over estimation of parasite growth within an infected host while others stated that evolution of parasitaemia seems to be quelled by parasite load. Various mathematical models have been designed to understand the dynamics of evolution of within-host malaria. The basic ingredient in most of the models is that the availability of uninfected red blood cells (RBCs) in which the parasite develops is a limiting factor in the propagation of the parasite population. We hypothesize that in severe malaria, due to parasite quest for survival and rapid multiplication, the vicious malaria parasite is sophisticated and can be absorbed in an already infected RBC and speeds up rapture rate. The study reviews the classical models of blood stage malaria and proposes a new model which incorporates double infection. Analysis of the model and parameter identifiability using Markov chain Monte Carlo (MCMC) are presented. MCMC uses distribution of parameters to study the model behavior instead of single points. Results indicate that most infected RBCs rupture quickly due to the disease instead. This may explain anemia in malaria patients and lack of uniformity of oscillations in within-host malaria. Therefore, more needs to be done as far as within-host malaria is concerned, to provide step by step evolution of malaria within a host.