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Fig. 7 | Malaria Journal

Fig. 7

From: Malaria parasite clearance

Fig. 7

Recrudescent falciparum malaria following administration of a slowly eliminated drug such as mefloquine, showing an example of the changes in total parasite numbers (blue) in the body as anti-malarial drug levels (red) first rise then fall. As drug levels fall below the minimum parasiticidal concentration (MPC) the rate of parasitaemia declines until it reaches reaching a temporary plateau, at which time the corresponding drug level is a minimum inhibitory concentration (MIC) [23, 117, 124]. Meanwhile levels of any dormant forms remain unchanged, while gametocyte densities rise as stage 5 gametocytes enter the circulation from sequestered sites. All contribute to qPCR parasite DNA measurements. Dormant forms are either cleared or “awaken” to form either asexual or sexual stages. The top right inset shows an individual patient example with female gametocyte specific Pfs 25 mRNA transcript densities shown in green and Pf18s DNA shown in blue (data from reference [124]). There are multiple mRNA transcripts per cell, but the rising DNA densities at the time of falling transcript numbers clearly indicates recrudescence

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