From multiplicity of infection to force of infection in sparsely sampled high-transmission Plasmodium falciparum populations

Abstract

High multiplicity of infection (MOI), the number of genetically distinct parasite strains co-infecting a host, characterizes falciparum malaria and other infectious diseases under high transmission. High MOI in Plasmodium falciparum accompanies high prevalence of asymptomatic infection despite high exposure, creating a large transmission reservoir that challenges intervention. This pattern is enabled by parasite immune evasion through extensive antigenic diversity. The force of infection (FOI), the number of new infections acquired by an individual host over a given time interval, is the dynamic counterpart of MOI and a key epidemiological parameter fo..