Résumé
BackgroundIn addition to curative treatment against the pathogenic asexual stages of malaria parasites, targeting the transmissible sexual stages is essential to impede the spread of drug resistance. The present study relies on a clinical trial testing the benefits of combining Atovaquone Proguanil (AP) with Artemether-lumefantrine (AL) in the treatment of uncomplicated malaria. AP has been shown to prevent transmission after treatment by affecting parasite development in mosquito vector Atovaquone exhibits additional properties where it persists in the serum of treated patients for days and is also known for hindering parasite development during ookinete to oocyst and oocyst to sporozoite transition. We hypothesize that pre-established P. falciparum infection in mosquitoes may be affected by metabolized drugs in patients’ blood when ingested during a blood meal. We therefore tested the effect of the ingestion by mosquitoes of blood from AL versus AL+AP treated patients on pre-established P. falciparum infection.MethodsEight time points (between Day 0 to Day 28) plasma from 24 patients treated with either AL+placebo or AL+AP has been collected for mosquito feeding. Infectious blood meal was provided to laboratory-reared female Anopheles mosquitoes and infected mosquitoes were exposed 4 days later to a second blood meal containing the plasma from treated patients. ResultsWe will present the effect of treatment and days post-treatment in patients, measured by comparing the infection prevalence and intensity among mosquitoes after dissection of a subset of exposed mosquitoes. The effect of treatment and time on the dynamics of sporozoite detection and mosquito survival will also be analysed. ConclusionThe present study will provide important data on alternative malaria treatments for their effect on vectorial transmission and will support decision-making for treatment policies.