Malaria remains one of the biggest causes of morbidity and mortality across the world, with 263 million cases and 597 000 deaths in 2023, with the latter primarily in Arican children under 5. The primary method for controlling malaria is through the use of insecticide-based vector control tools, targeting the adult female Anopheles mosquito, thereby preventing infection. Indeed, together, the use of insecticide treated bed nets and indoor residual spraying accounted for over 80% of all cases averted between 2000 and 2015. The remaining 20% was due to the use of curative drugs, usually in the form of artemisinin combination therapies, the front-line control for malaria. Unsurprisingly, the intense selection pressure on both the mosquito and parasite has led to the evolution of resistance to both insecticides and drugs, and, alarmingly, there has been a recent emergence and spread of artemisinin partial resistance in East Africa. Despite the importance of both insecticides and drugs in malaria control, we have little understanding of the impact of insecticide resistance or exposure on the development of the malaria parasite within the mosquito and thus transmission. Similarly, the changes in the parasite fitness due to drug resistance are well understood at blood stage but the competitive changes within the mosquito host remain largely uncharacterised. Within this project, these two key questions will be addressed using infectious feeds with the human malaria parasite P. falciparum and a combination of tools including phenotyping, molecular biology, CRISPR-Cas9, imaging, field work and multi-omics. Together, this project will aid in understanding the impacts of these two important phenotypes and shed light on the underlying mechanisms resulting in the changes observed through the following questions:
1. How is Plasmodium falciparum development in the mosquito affected by insecticide use?
2. Do drug resistance mutations in Plasmodium impact fitness during development within the Anopheles host?
3. What is the genetic interplay between parasite infection and insecticide response?