@article{fdi:010083815,
  title = {{T}he rare, the best : spread of antimalarial-resistant {P}lasmodium falciparum parasites by {A}nopheles mosquito vectors},
  author = {{B}erry, {A}. and {M}enard, {S}. and {N}sango, {S}. {E}. and {A}bate, {L}uc and {C}oncordet, {D}. and {T}sapi, {M}. {T}. and {I}riart, {X}. and {A}wono-{A}mbene, {P}. {H}. and {R}oche, {B}enjamin and {M}orlais, {I}sabelle},
  editor = {},
  language = {{ENG}},
  abstract = {{T}he emergence of resistance to antimalarials has prompted the steady switch to novel therapies for decades. {W}ithdrawal of antimalarials, such as chloroquine in sub-{S}aharan {A}frica in the late 1990s, led to rapid declines in the prevalence of resistance markers after a few years, raising the possibility of reintroducing them for malaria treatment. {H}ere, we provide evidence that the mosquito vector plays a crucial role in maintaining parasite genetic diversity. {W}e followed the transmission dynamics of {P}lasmodium falciparum parasites through its vector in natural infections from gametocytes contained in the blood of asymptomatic volunteers until sporozoites subsequently developed in the mosquito salivary glands. {W}e did not find any selection of the mutant or wild-type pfcrt 76 allele during development in the {A}nopheles mosquito vector. {H}owever, microsatellite genotyping indicated that minority genotypes were favored during transmission through the mosquito. {T}he analysis of changes in the proportions of mutant and wild-type pfcrt 76 alleles showed that, regardless of the genotype, the less-represented allele in the gametocyte population was more abundant in mosquito salivary glands, indicating a selective advantage of the minority allele in the vector. {S}election of minority genotypes in the vector would explain the persistence of drug-resistant alleles in the absence of drug pressure in areas with high malaria endemicity and high genetic diversity. {O}ur results may have important epidemiological implications, as they predict the rapid re-emergence and spread of resistant genotypes if antimalarials that had previously selected resistant parasites are reintroduced for malaria prevention or treatment. {IMPORTANCE} {D}rug selection pressure in malaria patients is the cause of the emergence of resistant parasites. {R}esistance imposes a fitness cost for parasites in untreated infections, so withdrawal of the drug leads to the return of susceptible parasites. {L}ittle is known about the role of the malaria vector in this phenomenon. {I}n an experimental study conducted in {C}ameroon, an area of high malaria transmission, we showed that the vector did not favor the parasites based on sensitivity or resistance criteria, but it did favor the selection of minority clones. {T}his finding shows that the vector increases the diversity of plasmodial populations and could play an important role in falciparum malaria epidemiology by maintaining resistant clones despite the absence of therapeutic pressure.},
  keywords = {malaria ; {A}nopheles ; transmission ; {P}lasmodium falciparum ; resistance ; antimalarials ; genetic diversity ; mosquito},
  booktitle = {},
  journal = {{M}icrobiology {S}pectrum},
  volume = {9},
  numero = {2},
  pages = {e00852--21 [11 ]},
  ISSN = {2165-0497},
  year = {2021},
  DOI = {10.1128/{S}pectrum.00852-21},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083815},
}