Fig. 1

Model schematic. Individuals are either susceptible; infected with disease in the latent stage (approximating liver-stage infection); or infectious to mosquitoes (approximating gametocyte/blood-stage). Infection can occur with wild-type or mutant strains, and people with wild-type infections can become classified as having mutant infections either by being bitten by mutant-carrying mosquitoes (limited by strain competition) or by undergoing a within-host mutation process (limited by strain competition and enhanced by drug pressure). Exposure and recovery increases immunity level—lowering the risk of transmission from mosquito to human and from human to mosquito—and in the absence of re-infection immunity level reduces over time. Recovery and immunity are not modelled for mosquitoes