ArticlePLoS biology2018
Within-host competition can delay evolution of drug resistance in malaria.
Article in PLoS biology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Spatio-temporal trends of the prevalence of Plasmodium falciparum antimalarial drug resistance markers across sub-Saharan Africa from 2010 to 2024: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- High prevalence and emerging positive association of kelch13 R622I and HRP2-based RDT negativity in Plasmodium falciparum in northern Ethiopia.PLoS pathogens · 2025Article
- Review
- Review
- Evaluation of Au(III) complexes as Plasmodium falciparum aquaglyceroporin (PfAQP) inhibitors by in silico and in vitro methods.Journal of biological inorganic chemistry : JBIC : a publication of the Society of Biological Inorganic Chemistry · 2024Article
- Temporal genomics in Southern Zambia shows rising prevalence of Plasmodium falciparum mutations linked to delayed clearance after artemisinin-lumefantrine treatment.Scientific reports · 2024Article
- Analysis of a diffusive two-strain malaria model with the carrying capacity of the environment for mosquitoes.Infectious Disease Modelling · 2024Article
- Impact of different mutations on Kelch13 protein levels, ART resistance, and fitness cost inmBio · 2024Article
- Temporal genomic analysis ofmedRxiv : the preprint server for health sciences · 2024Article
- SNP-slice resolves mixed infections: simultaneously unveiling strain haplotypes and linking them to hosts.Bioinformatics (Oxford, England) · 2024Article
- Role of seasonal importation and genetic drift on selection for drug-resistant genotypes ofJournal of the Royal Society, Interface · 2024Article
- Article
- A Comparative Study of Genetic Diversity and Multiplicity of Infection in UncomplicatedPathogens (Basel, Switzerland) · 2024Article
- Antigenic strain diversity predicts different biogeographic patterns of maintenance and decline of anti-malarial drug resistance.bioRxiv : the preprint server for biology · 2023Article
- Critical interdependencies between Plasmodium nutrient flux and drugs.Trends in parasitology · 2023Review
- Sampling for malaria molecular surveillance.Trends in parasitology · 2023Review
- Role of Seasonal Importation and Random Genetic Drift on Selection for Drug-Resistant Genotypes ofbioRxiv : the preprint server for biology · 2023Article
- In vitro and in vivo antiplasmodial evaluation of sugar-modified nucleoside analogues.Scientific reports · 2023Article
- Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique.Communications biology · 2023Article
- Resolving drug selection and migration in an inbred South American Plasmodium falciparum population with identity-by-descent analysis.PLoS pathogens · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the malaria parasite P. falciparum, drug resistance generally evolves first in low-transmission settings, such as Southeast Asia and South America. Resistance takes noticeably longer to appear in the high-transmission settings of sub-Saharan Africa, although it may spread rapidly thereafter. Here, we test the hypothesis that competitive suppression of drug-resistant parasites by drug-sensitive parasites may inhibit evolution of resistance in high-transmission settings, where mixed-strain infections are common. We employ a cross-scale model, which simulates within-host (infection) dynamics and between-host (transmission) dynamics of sensitive and resistant parasites for a population of humans and mosquitoes. Using this model, we examine the effects of transmission intensity, selection pressure, fitness costs of resistance, and cross-reactivity between strains on the establishment and spread of resistant parasites. We find that resistant parasites, introduced into the population at a low frequency, are more likely to go extinct in high-transmission settings, where drug-sensitive competitors and high levels of acquired immunity reduce the absolute fitness of the resistant parasites. Under strong selection from antimalarial drug use, however, resistance spreads faster in high-transmission settings than low-transmission ones. These contrasting results highlight the distinction between establishment and spread of resistance and suggest that the former but not the latter may be inhibited in high-transmission settings. Our results suggest that within-host competition is a key factor shaping the evolution of drug resistance in P. falciparum.
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