Figure 1.

The Plasmodium falciparum life cycle. The life cycle has three broad phases: sexual reproduction in the mosquito vector (grey shaded area), asexual reproduction in the liver (exo-erythrocytic developmental cycle, EDC, in dark pink) and asexual reproduction (intra-erythrocytic developmental cycle, IDC) and gametocyte differentiation in erythrocytes (light pink). Transmission to humans is initiated by ~10² sporozoites, which migrate to the liver through peripheral circulation to liver cells and replicate to form hepatic schizonts (hS). Hepatic asexually committed merozoites (M), released into the bloodstream, infect erythrocytes to initiate the IDC where parasites develop through ring (R), early trophozoite (eT), mature trophozoite (mT) and asexual schizont (aS) in 48 h, resulting in 10¹¹ parasites. Gametocyte-committed schizonts (cS) results in either male or female committed rings (cR) that mature in extravascular spaces (e.g., bone marrow). P. falciparum gametocytes have five distinct morphological stages during development, stage I-IV as immature gametocytes taking ~10 days to form and ~10^7-9 mature male and female stage V gametocytes returning to the circulatory system (~days 10-12), to be transmitted (~10³ gametocytes) to the mosquito. This is followed by gamete activation, fertilization, and production of an oocyst for sporogony. Created and modified with BioRender.com.