ArticleMalaria journal2026
Behavioral factors associated with artemisinin resistance: linking community treatment practices with pfkelch13 mutations in Northern Uganda.
Article in Malaria journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundUganda is listed among the few African countries where artemisinin partial resistance has already emerged. It has been increasing there since 2017, providing a unique opportunity to track the dynamics of its spread. Although selection of artemisinin resistant parasites by sub-optimal dosing has been suggested in vitro, epidemiological evidence that community knowledge, attitudes, and practices (KAP) toward treatment seeking or adherence affect the spread of artemisinin resistance is lacking.
methodsIn 2023, we conducted active case detection of Plasmodium falciparum (Pf) malaria in 15 villages of Gulu city, Northern Uganda. With informed consent, blood samples were collected and used for 18S ribosomal DNA PCR for Pf detection and subsequent genotyping of pfkelch13 gene by direct sequencing. Structured interviews were administered to household heads to assess their KAP regarding malaria prevention and treatment-seeking behaviors. Factors associated with Pf infection and the presence of WHO-validated artemisinin partial resistance mutations were analyzed using multiple linear regression models.
resultsA total of 1249 participants from 298 households were enrolled, and the overall Pf prevalence by PCR was 20.7%. Prevalence was highest in school-aged children (6-17 years; 31.5%), followed by adults (≥ 18 years; 18.2%). The risk of Pf infection among the general population was 10% higher in households lacking sustained bed net use for children (95% CI 1.1-18.9), 6.9% higher in households with lower educational levels (95% CI 0.8-12.9), and 9.7% higher in rural households (95% CI 4.5-14.9). The overall prevalence of C469Y and A675V validated pfkelch13 mutations was 23.9% and was highest in school-aged children (30.5%). Importantly, the prevalence of C469Y or A675V mutation was 13.1% higher in households where individuals did not consistently take the correct antimalarial dosage (95% CI 0.5-25.6).
conclusionsImproper bed net use and non-adherence to the antimalarial regimen were associated with a higher risk of Pf infection and artemisinin resistance mutations, underscoring the need for community-based education to reduce the further spread of these mutations. As school-aged children represent the largest reservoir of Pf and artemisinin resistance mutations presence, targeted preventive measures and interventions for this age group are essential.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.