Abstract
The spread of insecticide resistance in Anopheles mosquitoes and drug resistance in malaria parasites is contributing to a global resurgence of malaria, and the generation of control tools that can overcome these issues is an urgent public health priority. We recently demonstrated that the transmission of Plasmodium falciparum parasites by Anopheles gambiae can be efficiently blocked when female mosquitoes contact the antimalarial atovaquone deposited on a treated surface, with no negative consequences on mosquito fitness. Here, we demonstrate that the transmission-blocking efficacy of mosquito-targeted atovaquone is maintained when highly insecticide resistant, field-derived Anopheles mosquitoes are exposed to this antimalarial, indicating that insecticide resistance mechanisms do not interfere with drug function. Moreover, this approach prevents transmission of field P. falciparum isolates, including an artemisinin resistant Kelch13 C580Y mutant, demonstrating that this strategy could prevent the spread of parasite mutations that induce resistance to front-line antimalarials. Finally, we show that ingestion of atovaquone in sugar solution is highly effective at limiting parasite development, including in ongoing infections. These data support the use of mosquito-targeted antimalarial interventions to potentiate and extend the efficacy of our best malaria control tools.
Competing Interest Statement
The authors have declared no competing interest.
