From low to high transmission: Diversity-dependent responses of Plasmodium falciparum population structure to transmission intensity

Abstract

Genetic surveillance is increasingly used to track malaria transmission, yet genomic metrics can respond nonlinearly to changes in transmission intensity and depend on the diversity already present in the parasite population. Here, we present a stochastic agent-based model of hu-man-mosquito transmission that integrates SEIS-like epidemiological dynamics with within-host Plasmodium falciparum haplotype dynamics. By varying the maximum mosquito biting rate and the initial parasite diversity, we examine how transmission intensity and standing diversity jointly shape mixed infections, recombination, and long-term population structure across a continuous transmission gradient. Our study revealed a sequential pattern in which increasing biting intensity first increases infection prevalence and multiplicity of infection, then expands opportunities for outcrossing, and only thereafter increases effective recombination and recombinant haplotype generation. These responses are strongest in low- to intermediate transmission and tend to plateau at higher transmission levels. Initial population diversity constrains the amount of diversity that can be maintained and the magnitude of recombination output, while temporal trajectories show that haplotype evenness can pass through transient non-equilibrium phases before stabilizing. Together, these results show that the structure of the parasite population is shaped not by trans-mission intensity alone but by its interaction with standing genetic diversity. Furthermore, this study works to clarify when and how genomic metrics reliably reflect transmission conditions across heterogeneous malaria settings.