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MATHEMATICAL MODELING OF THE IMPACT OF MALARIA VACCINES ON THE CLINICAL EPIDEMIOLOGY AND NATURAL HISTORY OF PLASMODIUM FALCIPARUM MALARIA: OVERVIEW

We report a major project to develop integrated mathematical models for predicting the epidemiologic and economic effects of malaria vaccines both at the individual and population level. The project has developed models of the within-host dynamics of Plasmodium falciparum that have been fitted to parasite density profiles from malariatherapy patients, and simulations of P. falciparum epidemiology fitted to field malariologic datasets from a large ensemble of settings across Africa. The models provide a unique platform for predicting both the short- and long-term effects of malaria vaccines on the burden of disease, allowing for the temporal dynamics of effects on immunity and transmission. We discuss how the models can be used to obtain robust cost-effectiveness estimates for a wide range of malaria vaccines and vaccination delivery strategies in different eco-epidemiologic settings. This paper outlines for a non-mathematical audience the approach we have taken and its underlying rationale.

Received September 18, 2005. Accepted for publication November 25, 2005.

Acknowledgments: We thank Dan Anderegg for editorial assistance, and the members of the Technical Advisory Group (Michael Alpers, Paul Coleman, David Evans, Brian Greenwood, Carol Levin, Kevin Marsh, F. Ellis McKenzie, Mark Miller, and Brian Sharp), the Project Management Team at the Program for Appropriate Technology in Health (PATH) Malaria Vaccine Initiative, and GlaxoSmithKline Biologicals S.A for their assistance.

Financial support: The mathematical modeling study was supported by the PATH Malaria Vaccine Initiative and GlaxoSmithKline Biologicals S.A.

Disclaimer: Publication of this report and the contents hereof do not necessarily reflect the endorsement, opinion, or viewpoints of the PATH Malaria Vaccine Initiative or GlaxoSmithKline Biologicals S.A.

^* Address correspondence to Thomas Smith, Swiss Tropical Insitute, Socinstrasse 57, PO Box CH-4002, Basel, Switzerland. E-mail: Thomas-A.Smith{at}unibas.ch

Authors’ addresses: Thomas Smith, Nicolas Maire, Amanda Ross, Fabrizio Tediosi, Guy Hutton, Jürg Utzinger, and Marcel Tanner, Swiss Tropical Institute, Socinstrasse 57, PO Box, CH-4002, Basel, Switzerland, Telephone: 41-61-284-8273, Fax: 41-61-284-8105, E-mails: Thomas-A.Smith{at}unibas.ch, nicolas.maire{at}unibas.ch, amanda.ross{at}unibas.ch, fabrizio.tediosi{at}unibas.ch, guy.hutton{at}unibas.ch, juerg.utzinger{at}unibas.ch, and marcel.tanner{at}unibas.ch. Gerry F. Killeen, Ifakara Health Research and Development Centre, Ifakara, Kilombero District, Tanzania, Telephone: 255-748-477-118, Fax: 255-23-262-5312, E-mail: gkilleen{at}ihrdc.or.tz. Louis Molineaux, Peney-Dessus, CH-1242 Satigny, Geneva, Switzerland. Klaus Dietz, Department of Medical Biometry, University of Tübingen, West-bahnhofstrasse 55, 72070 Tübingen, Germany, Telephone: 49-7071-29-78253, Fax: 49-7071-29-5075, E-mail: klaus.dietz{at}unituebingen.de.

Reprint requests: Thomas Smith, Swiss Tropical Institute, Socinstrasse 57, PO Box, CH-4002, Basel, Switzerland.

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