How does within-host dynamics affect population-level dynamics? Insights from an immuno-epidemiological model of malaria. (English) Zbl 1383.92078
Summary: Malaria is one of the most common mosquito-borne diseases widespread in the tropical and subtropical regions. Few models coupling the within-host malaria dynamics with the between-host mosquito-human dynamics have been developed. In this paper, by adopting the nested approach, a malaria transmission model with immune response of the host is formulated. Applying age-structured partial differential equations for the between-host dynamics, we describe the asymptomatic and symptomatic infectious host population for malaria transmission. The basic reproduction numbers for the within-host model and for the coupled system are derived, respectively. The existence and stability of the equilibria of the coupled model are analyzed. We show numerically that the within-host model can exhibit complex dynamical behavior, possibly even chaos. In contrast, equilibria in the immuno-epidemiological model are globally stable and their stabilities are determined by the reproduction number. Increasing the activation rate of the within-host immune response “dampens” the sensitivity of the population level reproduction number and prevalence to the increase of the within-host reproduction of the pathogen. From public health perspective this means that treatment in a population with higher immunity has less impact on the population-level reproduction number and prevalence than in a population with less immunity.
Keywords:
age since infection; basic reproduction number; global stability; immuno-epidemiology; Lyapunov functional; malaria; oscillations; vector-host modelReferences:
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