The emergence of drug-resistant malaria.

Stochastic processes play a vital role in the early stages of the evolution of drug-resistant malaria. We present a simple and flexible method for investigating these processes and understanding how they affect the emergence of drug-resistant malaria. Qualitatively different predictions can be made...

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Main Authors: Hastings, I, Mackinnon, M
Format: Journal article
Language:English
Published: 1998
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author Hastings, I
Mackinnon, M
author_facet Hastings, I
Mackinnon, M
author_sort Hastings, I
collection OXFORD
description Stochastic processes play a vital role in the early stages of the evolution of drug-resistant malaria. We present a simple and flexible method for investigating these processes and understanding how they affect the emergence of drug-resistant malaria. Qualitatively different predictions can be made depending on the biological and epidemiological factors which prevail in the field. Intense intra-host competition between co-infecting clones, low numbers of genes required to encode resistance, and high drug usage all encourage the emergence of drug resistance. Drug-resistant forms present at the time drug application starts are less likely to survive than those which arise subsequently; survival of the former largely depends on how rapidly malaria population size stabilizes after drug application. In particular, whether resistance is more likely to emerge in areas of high or low transmission depends on malaria intra-host dynamics, the level of drug usage, the population regulation of malaria, and the number of genes required to encode resistance. These factors are discussed in relation to the practical implementation of drug control programmes.
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spelling oxford-uuid:e6670fdc-1011-4fb5-a5d7-dee5232e9e302022-03-27T10:30:48ZThe emergence of drug-resistant malaria.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e6670fdc-1011-4fb5-a5d7-dee5232e9e30EnglishSymplectic Elements at Oxford1998Hastings, IMackinnon, MStochastic processes play a vital role in the early stages of the evolution of drug-resistant malaria. We present a simple and flexible method for investigating these processes and understanding how they affect the emergence of drug-resistant malaria. Qualitatively different predictions can be made depending on the biological and epidemiological factors which prevail in the field. Intense intra-host competition between co-infecting clones, low numbers of genes required to encode resistance, and high drug usage all encourage the emergence of drug resistance. Drug-resistant forms present at the time drug application starts are less likely to survive than those which arise subsequently; survival of the former largely depends on how rapidly malaria population size stabilizes after drug application. In particular, whether resistance is more likely to emerge in areas of high or low transmission depends on malaria intra-host dynamics, the level of drug usage, the population regulation of malaria, and the number of genes required to encode resistance. These factors are discussed in relation to the practical implementation of drug control programmes.
spellingShingle Hastings, I
Mackinnon, M
The emergence of drug-resistant malaria.
title The emergence of drug-resistant malaria.
title_full The emergence of drug-resistant malaria.
title_fullStr The emergence of drug-resistant malaria.
title_full_unstemmed The emergence of drug-resistant malaria.
title_short The emergence of drug-resistant malaria.
title_sort emergence of drug resistant malaria
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