ArticleThe Journal of infectious diseases2014
Directional selection at the pfmdr1, pfcrt, pfubp1, and pfap2mu loci of Plasmodium falciparum in Kenyan children treated with ACT.
Article in The Journal of infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 1 of them a synthesis that pooled it.
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Who cites it
88 citing papers in PubMed, 1 synthesis or guideline pooled it, 136 citations in OpenAlex.
- Drug resistance of Plasmodium falciparum and Plasmodium vivax isolates in Indonesia.Malaria journal · 2022Pooled it
- Trial
- Trial
- Artesunate/Amodiaquine Versus Artemether/Lumefantrine for the Treatment of Uncomplicated Malaria in Uganda: A Randomized Trial.The Journal of infectious diseases · 2016Trial
- Changes in molecular markers of Plasmodium falciparum drug resistance between 2017 and 2024 in Southern Benin.International journal for parasitology. Drugs and drug resistance · 2026Article
- Drug resistance gene polymorphisms of Plasmodium falciparum clinical isolates from Kinshasa, Democratic Republic of the Congo.Tropical medicine and health · 2026Article
- Prevalence of molecular markers related to artemisinin partial resistance and ACT partner drug resistance in the Plasmodium falciparum population in Kongo Central, DRC.Malaria journal · 2026Article
- Article
- Hemoglobin Digestion Genes Are Conserved in Lizard-InfectiveEcology and evolution · 2026Article
- National genomic profiling of Plasmodium falciparum antimalarial resistance in Zambian children participating in the 2018 malaria indicator survey.Scientific reports · 2026Article
- NovelmBio · 2026Article
- A scoping review of antimalarial drug resistance markers in Kenya (1987-2022): toward a National Surveillance Framework and Data Repository.Malaria journal · 2025Article
- Multiplex long-amplicon sequencing for comprehensive molecular surveillance of Plasmodium falciparum resistance to artemisinin and partner drugs in artemisinin-based combination therapies (ACTs).Parasites & vectors · 2025Article
- Review
- A NovelmedRxiv : the preprint server for health sciences · 2025Article
- A Narrative Review on the Prevalence ofTropical medicine and infectious disease · 2025Review
- Polymorphisms in Pfkelch13 domains before and after the introduction of artemisinin-based combination therapy in Southwest Nigeria.PloS one · 2025Article
- Temporal genomics in Southern Zambia shows rising prevalence of Plasmodium falciparum mutations linked to delayed clearance after artemisinin-lumefantrine treatment.Scientific reports · 2024Article
- Risk of selection and timelines for the continued spread of artemisinin and partner drug resistance in Africa.medRxiv : the preprint server for health sciences · 2024Article
- Impact of different mutations on Kelch13 protein levels, ART resistance, and fitness cost inmBio · 2024Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundThe efficacy of artemisinin-based combination therapy (ACT) for Plasmodium falciparum malaria may be threatened by parasites with reduced responsiveness to artemisinins. Among 298 ACT-treated children from Mbita, Kenya, submicroscopic persistence of P. falciparum on day 3 posttreatment was associated with subsequent microscopically detected parasitemia at days 28 or 42.
methodsDNA sequences of resistance-associated parasite loci pfcrt, pfmdr1, pfubp1, and pfap2mu were determined in the Mbita cohort before treatment, on days 2 and 3 after initiation of treatment, and on the day of treatment failure.
resultsParasites surviving ACT on day 2 or day 3 posttreatment were significantly more likely than the baseline population to carry the wild-type haplotypes of pfcrt (CVMNK at codons 72-76; P < .001) and pfmdr1 (NFD at codons 86, 184, 1246; P < .001). In contrast, variant alleles of the novel candidate resistance genes pfap2mu (S160N/T; P = .006) and pfubp-1 (E1528D; P < .001) were significantly more prevalent posttreatment. No genetic similarities were found to artemisinin-tolerant parasites recently described in Cambodia.
conclusionsAmong treated children in western Kenya, certain P. falciparum genotypes defined at pfcrt, pfmdr1, pfap2mu, and pfubp1 more often survive ACT at the submicroscopic level, and contribute to onward transmission and subsequent patent recrudescence.
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