{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:00:52Z","timestamp":1790352052595,"version":"4.1.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R01-TW009670"],"award-info":[{"award-number":["R01-TW009670"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ecology and Evolution of Infectious Diseases"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The majority of Plasmodium falciparum infections, constituting the reservoir in all ages, are asymptomatic in high-transmission settings in Africa. The role of this reservoir in the evolution and spread of drug resistance was explored.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Population genetic analyses of the key drug resistance\u2013mediating polymorphisms were analyzed in a cross-sectional survey of asymptomatic P. falciparum infections across all ages in Bongo District, Ghana.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seven years after the policy change to artemisinin-based combination therapies in 2005, the pfcrt K76 and pfmdr1 N86 wild-type alleles have nearly reached fixation and have expanded via soft selective sweeps on multiple genetic backgrounds. By constructing the pfcrt-pfmdr1-pfdhfr-pfdhps multilocus haplotypes, we found that the alleles at these loci were in linkage equilibrium and that multidrug-resistant parasites have not expanded in this reservoir. For pfk13, 32 nonsynonymous mutations were identified; however, none were associated with artemisinin-based combination therapy resistance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The prevalence and selection of alleles\/haplotypes by antimalarials were similar to that observed among clinical cases in Ghana, indicating that they do not represent 2 subpopulations with respect to these markers. Thus, the P. falciparum reservoir in all ages can contribute to the maintenance and spread of antimalarial resistance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaa286","type":"journal-article","created":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T11:44:21Z","timestamp":1590147861000},"page":"1692-1701","source":"Crossref","is-referenced-by-count":21,"title":["Evolution of Antimalarial Drug Resistance Markers in the Reservoir of <i>Plasmodium falciparum<\/i> Infections in the Upper East Region of Ghana"],"prefix":"10.1093","volume":"222","author":[{"given":"Charles A","family":"Narh","sequence":"first","affiliation":[{"name":"Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana"},{"name":"School of BioSciences, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Ghansah","sequence":"additional","affiliation":[{"name":"Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael F","family":"Duffy","sequence":"additional","affiliation":[{"name":"School of BioSciences, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute, Melbourne, Australia"},{"name":"Department of Microbiology and Immunology, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute and Peter Doherty Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shazia","family":"Ruybal-Pes\u00e1ntez","sequence":"additional","affiliation":[{"name":"School of BioSciences, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana O","family":"Onwona","sequence":"additional","affiliation":[{"name":"Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham R","family":"Oduro","sequence":"additional","affiliation":[{"name":"Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwadwo A","family":"Koram","sequence":"additional","affiliation":[{"name":"Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen P","family":"Day","sequence":"additional","affiliation":[{"name":"School of BioSciences, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute, Melbourne, Australia"},{"name":"Department of Microbiology and Immunology, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute and Peter Doherty Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3305-0533","authenticated-orcid":false,"given":"Kathryn E","family":"Tiedje","sequence":"additional","affiliation":[{"name":"School of BioSciences, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute, Melbourne, Australia"},{"name":"Department of Microbiology and Immunology, The University of Melbourne, Bio21 Molecular Science and Biotechnology Institute and Peter Doherty Institute, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"2021032205550990600_CIT0001","doi-asserted-by":"crossref","DOI":"10.30875\/7e6f8c91-en","volume-title":"World malaria report 2019","author":"World Health 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