Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model
<h4>Background</h4> <p>Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong Subregion, an area of relatively low transmission, but has yet to be reported in Africa. A population-based mathematical model was used to investigate the relationship between P. f...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
BioMed Central
2018
|
| _version_ | 1797091752935424000 |
|---|---|
| author | Scott, N Ataide, R Wilson, D Hellard, M Price, R Simpson, J Fowkes, F |
| author_facet | Scott, N Ataide, R Wilson, D Hellard, M Price, R Simpson, J Fowkes, F |
| author_sort | Scott, N |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong Subregion, an area of relatively low transmission, but has yet to be reported in Africa. A population-based mathematical model was used to investigate the relationship between P. falciparum prevalence, exposure-acquired immunity and time-to-emergence of artemisinin resistance. The possible implication for the emergence of resistance across Africa was assessed.</p> <h4>Methods</h4> <p>The model included human and mosquito populations, two strains of malaria (“wild-type”, “mutant”), three levels of human exposure-acquired immunity (none, low, high) with two types of immunity for each level (sporozoite/liver stage immunity and blood-stage/gametocyte immunity) and drug pressure based on per-capita treatment numbers.</p> <h4>Results</h4> <p>The model predicted that artemisinin-resistant strains may circulate up to 10 years longer in high compared to low P. falciparum prevalence areas before resistance is confirmed. Decreased time-to-resistance in low prevalence areas was explained by low genetic diversity and immunity, which resulted in increased probability of selection and spread of artemisinin-resistant strains. Artemisinin resistance was estimated to be established by 2020 in areas of Africa with low (< 10%) P. falciparum prevalence, but not for 5 or 10 years later in moderate (10–25%) or high (> 25%) prevalence areas, respectively.</p> <h4>Conclusions</h4> <p>Areas of low transmission and low immunity give rise to a more rapid expansion of artemisinin-resistant parasites, corroborating historical observations of anti-malarial resistance emergence. Populations where control strategies are in place that reduce malaria transmission, and hence immunity, may be prone to a rapid emergence and spread of artemisinin-resistant strains and thus should be carefully monitored.</p> |
| first_indexed | 2024-03-07T03:37:06Z |
| format | Journal article |
| id | oxford-uuid:bcab2948-920e-47e9-96a3-44ba3b131edb |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:37:06Z |
| publishDate | 2018 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:bcab2948-920e-47e9-96a3-44ba3b131edb2022-03-27T05:26:03ZImplications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical modelJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bcab2948-920e-47e9-96a3-44ba3b131edbEnglishSymplectic Elements at OxfordBioMed Central2018Scott, NAtaide, RWilson, DHellard, MPrice, RSimpson, JFowkes, F <h4>Background</h4> <p>Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong Subregion, an area of relatively low transmission, but has yet to be reported in Africa. A population-based mathematical model was used to investigate the relationship between P. falciparum prevalence, exposure-acquired immunity and time-to-emergence of artemisinin resistance. The possible implication for the emergence of resistance across Africa was assessed.</p> <h4>Methods</h4> <p>The model included human and mosquito populations, two strains of malaria (“wild-type”, “mutant”), three levels of human exposure-acquired immunity (none, low, high) with two types of immunity for each level (sporozoite/liver stage immunity and blood-stage/gametocyte immunity) and drug pressure based on per-capita treatment numbers.</p> <h4>Results</h4> <p>The model predicted that artemisinin-resistant strains may circulate up to 10 years longer in high compared to low P. falciparum prevalence areas before resistance is confirmed. Decreased time-to-resistance in low prevalence areas was explained by low genetic diversity and immunity, which resulted in increased probability of selection and spread of artemisinin-resistant strains. Artemisinin resistance was estimated to be established by 2020 in areas of Africa with low (< 10%) P. falciparum prevalence, but not for 5 or 10 years later in moderate (10–25%) or high (> 25%) prevalence areas, respectively.</p> <h4>Conclusions</h4> <p>Areas of low transmission and low immunity give rise to a more rapid expansion of artemisinin-resistant parasites, corroborating historical observations of anti-malarial resistance emergence. Populations where control strategies are in place that reduce malaria transmission, and hence immunity, may be prone to a rapid emergence and spread of artemisinin-resistant strains and thus should be carefully monitored.</p> |
| spellingShingle | Scott, N Ataide, R Wilson, D Hellard, M Price, R Simpson, J Fowkes, F Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
| title | Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
| title_full | Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
| title_fullStr | Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
| title_full_unstemmed | Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
| title_short | Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
| title_sort | implications of population level immunity for the emergence of artemisinin resistant malaria a mathematical model |
| work_keys_str_mv | AT scottn implicationsofpopulationlevelimmunityfortheemergenceofartemisininresistantmalariaamathematicalmodel AT ataider implicationsofpopulationlevelimmunityfortheemergenceofartemisininresistantmalariaamathematicalmodel AT wilsond implicationsofpopulationlevelimmunityfortheemergenceofartemisininresistantmalariaamathematicalmodel AT hellardm implicationsofpopulationlevelimmunityfortheemergenceofartemisininresistantmalariaamathematicalmodel AT pricer implicationsofpopulationlevelimmunityfortheemergenceofartemisininresistantmalariaamathematicalmodel AT simpsonj implicationsofpopulationlevelimmunityfortheemergenceofartemisininresistantmalariaamathematicalmodel AT fowkesf implicationsofpopulationlevelimmunityfortheemergenceofartemisininresistantmalariaamathematicalmodel |