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Within-host competition can delay evolution of drug resistance in malaria

Fig 9

Introduction of resistant parasites into populations with varying levels of antimalarial drug use and fitness costs of resistance.

Panels A–I vary in treatment rate (daily probability of infected host starting treatment) and fitness cost (proportional reduction in within-host growth rate for the resistant type). As in Figs 7 and 8, each four-part panel presents results for (i) low transmission/high cross-reactivity, (ii) high transmission/high cross-reactivity, (iii) low transmission/low cross-reactivity, and (iv) high transmission/low cross-reactivity. For all figures, solid lines and shaded areas show mean and range of 3 independent simulations (blue, red, and black representing infections with sensitive, resistant, or both types of parasites, respectively). Note that in some panels, such as C(ii), shading for one or more colors covers a wide area; this is generally caused by the resistant strain going extinct in some but not all of the replicate simulations.

Fig 9