Early transmission of sensitive strain slows down emergence of drug resistance in Plasmodium vivax

PLoS Comput Biol. 2020 Jun 17;16(6):e1007945. doi: 10.1371/journal.pcbi.1007945. eCollection 2020 Jun.

Abstract

The spread of drug resistance of Plasmodium falciparum and Plasmodium vivax parasites is a challenge towards malaria elimination. P. falciparum has shown an early and severe drug resistance in comparison to P. vivax in various countries. In fact, P. vivax differs in its life cycle and treatment in various factors: development and duration of sexual parasite forms differ, symptoms severity are unequal, relapses present only in P. vivax cases and the Artemisinin-based combination therapy (ACT) is only mandatory in P. falciparum cases. We compared the spread of drug resistance for both species through two compartmental models using ordinary differential equations. The model structure describes how sensitive and resistant parasite strains infect a human population treated with antimalarials. We found that an early transmission,i.e., before treatment and low effectiveness of drug coverage, supports the prevalence of sensitive parasites delaying the emergence of resistant P. vivax. These results imply that earlier attention of both symptomatic cases and reservoirs of P. vivax are essential in controlling transmission but also accelerate the spread of drug resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / pharmacology*
  • Drug Resistance*
  • Humans
  • Malaria, Vivax / psychology
  • Malaria, Vivax / transmission*
  • Plasmodium vivax / drug effects*

Substances

  • Antimalarials

Grants and funding

MA and DV are grateful for support from Program Print-Fiocruz-CAPES, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, http://www.capes.gov.br), and Fundação Oswaldo Cruz (Fiocruz, http://www.fiocruz.br), and MA is grateful for the scholarship support from Instituto Oswaldo Cruz (IOC, http://www.ioc.fiocruz.br) in the graduate program. DV has support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development - CNPq, http://www.cnpq.br, Ref. 424141/2018-3, 309569/2019-2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.