Differential drivers of intraspecific and interspecific competition during malaria-helminth co-infection

L. F. Wait, T. Kamiya, K. J. Fairlie-Clarke, C. J.E. Metcalf, A. L. Graham, N. Mideo

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Various host and parasite factors interact to determine the outcome of infection. We investigated the effects of two factors on the within-host dynamics of malaria in mice: initial infectious dose and co-infection with a helminth that limits the availability of red blood cells (RBCs). Using a statistical, time-series approach to model the within-host 'epidemiology' of malaria, we found that increasing initial dose reduced the time to peak cell-to-cell parasite propagation, but also reduced its magnitude, while helminth co-infection delayed peak cell-to-cell propagation, except at the highest malaria doses. Using a mechanistic model of within-host infection dynamics, we identified dose-dependence in parameters describing host responses to malaria infection and uncovered a plausible explanation of the observed differences in single vs co-infections. Specifically, in co-infections, our model predicted a higher background death rate of RBCs. However, at the highest dose, when intraspecific competition between malaria parasites would be highest, these effects of co-infection were not observed. Such interactions between initial dose and co-infection, although difficult to predict a priori, are key to understanding variation in the severity of disease experienced by hosts and could inform studies of malaria transmission dynamics in nature, where co-infection and low doses are the norm.

Original languageEnglish (US)
Pages (from-to)1030-1039
Number of pages10
Issue number9
StatePublished - Aug 2021

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Animal Science and Zoology
  • Parasitology


  • Co-infection
  • dose dependence
  • hookworm
  • infectious dose
  • malaria
  • within-host


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