# name
Relevance of Undetectably Rare Resistant Malaria Parasites in
                Treatment Failure: Experimental Evidence from Plasmodium
                chabaudi

# metadata.dc.description.abstract[].value
Resistant malaria parasites are frequently found in mixed
                infections with drug-sensitive parasites. Particularly early in
                the evolutionary process, the frequency of these resistant
                mutants is extremely low and below the level of molecular
                detection. We tested whether the rarity of resistance in
                infections impacted the health outcomes of treatment failure and
                the potential for onward transmission of resistance. Mixed
                infections of different ratios of resistant and susceptible
                Plasmodium chabaudi parasites were inoculated in laboratory mice
                and dynamics tracked during the course of infection using highly
                sensitive genotype-specific quantitative polymerase chain
                reaction (qPCR). Frequencies of resistant parasites ranged from
                10% to 0.003% at the onset of treatment. We found that the rarer
                the resistant parasites were, the lower the likelihood of their
                onward transmission, but the worse the treatment failure was in
                terms of parasite numbers and disease severity. Strikingly, drug
                resistant parasites had the biggest impact on health outcomes
                when they were too rare to be detected by any molecular methods
                currently available for field samples. Indeed, in the field,
                these treatment failures would not even have been attributed to
                resistance.

# metadata.dc.publisher[].value
The American Society of Tropical Medicine and Hygiene

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.4269/ajtmh.15-0036

# metadata.dc.relation.ispartof[].value
The American Journal of Tropical Medicine and Hygiene, 2015,
                vol. 92, num. 6, p. 1214-1221

# metadata.dc.rights[].value
(c) The American Society of Tropical Medicine and Hygiene, 2015

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Relevance of Undetectably Rare Resistant Malaria Parasites in
                Treatment Failure: Experimental Evidence from Plasmodium
                chabaudi