Abstract
Artemisinin-resistant Plasmodium falciparum parasites are rapidly spreading in Southeast Asia, yet nothing is known about their transmission. This knowledge gap and the possibility that these parasites will spread to Africa endanger global efforts to eliminate malaria. Here we produce gametocytes from parasite clinical isolates that displayed artemisinin resistance in patients and in vitro, and use them to infect native and non-native mosquito vectors. We show that contemporary artemisinin-resistant isolates from Cambodia develop and produce sporozoites in two Southeast Asian vectors, Anopheles dirus and Anopheles minimus, and the major African vector, Anopheles coluzzii (formerly Anopheles gambiae M). The ability of artemisinin-resistant parasites to infect such highly diverse Anopheles species, combined with their higher gametocyte prevalence in patients, may explain the rapid expansion of these parasites in Cambodia and neighbouring countries, and further compromise efforts to prevent their global spread.
Highlights
Artemisinin-resistant Plasmodium falciparum parasites are rapidly spreading in Southeast Asia, yet nothing is known about their transmission
Despite the alarming potential of ART resistance spreading throughout the Greater Mekong Subregion (GMS) and to Africa, we still do not know whether Cambodian founder populations can infect major Southeast Asian malaria vectors or An. coluzzii and An. gambiae[23], the two major African vectors
Parasite isolates were tested in recently adapted colonies of An. dirus from Pursat Province, Western Cambodia, and An. coluzzii from Theirola, Mali; a longterm-adapted colony of An. minimus from Western Thailand; and two long-term-adapted Anopheles stephensi Nijmegen and An. gambiae G3 lines
Summary
Artemisinin-resistant Plasmodium falciparum parasites are rapidly spreading in Southeast Asia, yet nothing is known about their transmission. The ability of artemisinin-resistant parasites to infect such highly diverse Anopheles species, combined with their higher gametocyte prevalence in patients, may explain the rapid expansion of these parasites in Cambodia and neighbouring countries, and further compromise efforts to prevent their global spread. To investigate the current transmission dynamics of P. falciparum, we produced gametocytes from parasite clinical isolates that displayed ART resistance or sensitivity in patients[6,11,12] and in vitro[13,14], and used them to infect native and non-native mosquito vectors. The ability of ART-resistant parasites to infect such diverse anophelines, combined with their higher gametocyte prevalence in patients[9], may be contributing to the rapid expansion of these parasites in Cambodia and other GMS countries
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