Transmission of Artemisinin-Resistant Malaria Parasites to Mosquitoes under Antimalarial Drug Pressure
Kathrin Witmer, Farah A. Dahalan, Michael J. Delves, Sabrina Yahiya, Oliver J. Watson, Ursula Straschil, Darunee Chiwcharoen, Boodtee Sornboon, Sasithon Pukrittayakamee, Richard D. Pearson, Virginia M. Howick, Mara Lawniczak, Nicholas J. White, Arjen M. Dondorp, Lucy Okell, Kesinee Chotivanich, Andrea Ruecker, Jake Baum
Abstract
male gamete formation assay. Importantly, this same reduction in sensitivity was observed when the most resistant isolate was tested directly in mosquito feeds. These results indicate that, under artemisinin drug pressure, while sensitive parasites are blocked, resistant parasites continue transmission. This selective advantage for resistance transmission could favor acquisition of additional host-specificity or polymorphisms affecting partner drug sensitivity in mixed infections. Favored resistance transmission under ACT coverage could have profound implications for the spread of multidrug-resistant malaria beyond Southeast Asia.