Eco-evolutionary dynamics of Plasmodium genotypes under mass drug administration

Mass Drug Administration (MDA) is regarded as a potential strategy for locally interrupting transmission of human malaria under specific circumstances. However, insights on how MDA affects the eco-evolutionary dynamics of different Plasmodium species are not well known. We provide a computational model where the ecologically explicit life cycle of the parasite is implemented. Since the parasite inhabits two different ecological niches - human host and the mosquito - it undergoes different selection pressures during its reproduction. We use the model to perform an evolutionary analysis of the dynamics of resistance alleles under atovaquone, chloroquine and combined atovaquone-chloroquine drug treatments. Our study shows how the reduced viability of resistant parasites in the mosquito affects the spread of resistance and transmission interruption in treated human populations. Overall, results confirm that the disadvantage of drug-resistant genotypes in the mosquito vector is a good tool to achieve malaria control goals under MDA programmes.\n\nAuthor summaryEvery year there are millions of new malaria cases reported worldwide. The cause of the disease is the infection by Plasmodium, a protozoan which is transmitted between humans through the bite of a mosquito. Antimalarials have existed since long, but Plasmodium has evolved resistance to the treatment, making it necessary to develop new strategies to heal the infected humans. Lately, it has been pointed out that mosquitoes could be our allies when using drugs such as atovaquone, which resistant parasites have difficulties to reproduce in the mosquito. Here we study the scenarios in which these drugs, used in Mass Drug Administration (MDA) programmes, can interrupt the transmission of malaria in local treated populations.