Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model
Abstract Background 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,...
Published in: | Malaria Journal |
---|---|
Main Authors: | , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
BMC
2018
|
Subjects: | |
Online Access: | https://doi.org/10.1186/s12936-018-2418-y https://doaj.org/article/629b04b4fdf1459d8566b6e6deb4e73b |
id |
ftdoajarticles:oai:doaj.org/article:629b04b4fdf1459d8566b6e6deb4e73b |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:629b04b4fdf1459d8566b6e6deb4e73b 2023-05-15T15:13:38+02:00 Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model Nick Scott Ricardo Ataide David P. Wilson Margaret Hellard Ric N. Price Julie A. Simpson Freya J. I. Fowkes 2018-08-01T00:00:00Z https://doi.org/10.1186/s12936-018-2418-y https://doaj.org/article/629b04b4fdf1459d8566b6e6deb4e73b EN eng BMC http://link.springer.com/article/10.1186/s12936-018-2418-y https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2418-y 1475-2875 https://doaj.org/article/629b04b4fdf1459d8566b6e6deb4e73b Malaria Journal, Vol 17, Iss 1, Pp 1-11 (2018) Africa Malaria Artemisinin Drug resistance Immunity Mathematical model Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2018 ftdoajarticles https://doi.org/10.1186/s12936-018-2418-y 2022-12-31T11:45:54Z Abstract Background 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. Methods 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. Results 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. Conclusions 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 17 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Africa Malaria Artemisinin Drug resistance Immunity Mathematical model Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Africa Malaria Artemisinin Drug resistance Immunity Mathematical model Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Nick Scott Ricardo Ataide David P. Wilson Margaret Hellard Ric N. Price Julie A. Simpson Freya J. I. Fowkes Implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
topic_facet |
Africa Malaria Artemisinin Drug resistance Immunity Mathematical model Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background 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. Methods 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. Results 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. Conclusions 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. |
format |
Article in Journal/Newspaper |
author |
Nick Scott Ricardo Ataide David P. Wilson Margaret Hellard Ric N. Price Julie A. Simpson Freya J. I. Fowkes |
author_facet |
Nick Scott Ricardo Ataide David P. Wilson Margaret Hellard Ric N. Price Julie A. Simpson Freya J. I. Fowkes |
author_sort |
Nick Scott |
title |
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_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_sort |
implications of population-level immunity for the emergence of artemisinin-resistant malaria: a mathematical model |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s12936-018-2418-y https://doaj.org/article/629b04b4fdf1459d8566b6e6deb4e73b |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 17, Iss 1, Pp 1-11 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s12936-018-2418-y https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2418-y 1475-2875 https://doaj.org/article/629b04b4fdf1459d8566b6e6deb4e73b |
op_doi |
https://doi.org/10.1186/s12936-018-2418-y |
container_title |
Malaria Journal |
container_volume |
17 |
container_issue |
1 |
_version_ |
1766344175824928768 |