An analysis of the temperature effects of fever on the intra-host population dynamics of Plasmodium falciparum.

Observations that growth of Plasmodium falciparum in vitro is inhibited by high temperatures have led to hypotheses that malaria fever may influence the parasite population dynamics, regulating parasite density and synchronizing parasite growth. In order to investigate the fever hypotheses, we have developed an age-structured coupled Markov chain model that describes the parasite erythrocyte cycle and its interaction with the host fever response. We estimated the model parameters using data collected from laboratory parasite cultures that were exposed to febrile or normal temperature. Using the experimental parameter values, quantitative predictions were made of the effect of fever in determining the parasite population dynamics. It was concluded from the model behaviour that, during the primary infection of a non-immune host, a typical episode of fever can effect density-dependent regulation of the parasite population, maintaining cycles of parasitaemia and promoting synchronous parasite growth.