{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:54:14Z","timestamp":1790920454101,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100021281","name":"Gates Foundation","doi-asserted-by":"publisher","award":["INV-048214"],"award-info":[{"award-number":["INV-048214"]}],"id":[{"id":"10.13039\/100021281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malaria control in the Horn of Africa faces growing challenges from emerging antimalarial resistance, diagnostic failures due to gene deletions, and the invasive Anopheles stephensi. In Djibouti, where artemether-lumefantrine (AL) has been the first-line treatment since 2014, no prior therapeutic efficacy studies (TES) had assessed in-country drug performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 28-day, single-arm TES was conducted at Arhiba Health Center in Djibouti City from 16 April 2024 to 5 May 2024, enrolling patients aged \u22656 months with uncomplicated Plasmodium falciparum malaria. Artemether-lumefantrine was administered under direct observation, with follow-up on days 1\u20133, 7, 14, 21, and 28 for clinical assessment, microscopy, rapid diagnostic tests (RDT), and qPCR. Molecular analyses included detection of resistance markers, gene deletions, parasite diversity, and identity-by-descent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 88 enrolled patients, 70 completed follow-ups. The PCR-adjusted adequate clinical and parasitological response (ACPR) was 98.6% (95% CI, 96.1\u2013100.0), with one recrudescence. Gametocytes were observed in 11.4% at baseline and persisted through day 21. HRP2-based RDT detected only 37.5% of infections compared to 100% using pLDH-based RDT, consistent with pfhrp2\/3 deletions (95.6%, 44\/46). Resistance markers included Pfk13 R622I (one case), PfCRT CVIET 90.9% (70\/77) and SVMNT 2.6% (2\/77), PfDHFR AIRNI 40.2% (31\/77) and PfDHPS ISGEAA 72.2% (52\/72), and PfMDR1 NFSND 96.1% (74\/77). Most infections were monoclonal (mean complexity of infection = 1.62) and exhibited high genetic relatedness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Artemether-lumefantrine remains effective in Djibouti; however, widespread pfhrp2\/3 deletions, persistent gametocytemia, and resistance markers underscore the need for integrated molecular surveillance and the adoption of transmission-blocking interventions such as single-dose primaquine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>Pan African Clinical Trial Registry (PACTR202508856741773).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag324","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T11:41:09Z","timestamp":1779536469000},"source":"Crossref","is-referenced-by-count":1,"title":["First TES in Djibouti: A Critical Milestone Amid Rising Regional Threats"],"prefix":"10.1093","volume":"13","author":[{"given":"Sinknesh Wolde","family":"Behaksra","sequence":"first","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]},{"name":"Department of Biotechnology, Addis Ababa University , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samatar Kayad","family":"Guelleh","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre Le Paludisme, Direction des Programmes de Sant\u00e9 Prioritaires, Minist\u00e8re de La Sant\u00e9 , Djibouti, Republic of \u00a0","place":["Djibouti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon","family":"Sisay","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yisihak Abreham","family":"Weldehana","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Mussa","family":"Weyesa","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tirhas","family":"Endale","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assia Adlao","family":"Hamad","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre Le Paludisme, Direction des Programmes de Sant\u00e9 Prioritaires, Minist\u00e8re de La Sant\u00e9 , Djibouti, Republic of \u00a0","place":["Djibouti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natnael Lemessa","family":"Hundera","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawit Hailu","family":"Alemayehu","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7609-2382","authenticated-orcid":false,"given":"Elias B","family":"Tafa","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Louie","sequence":"additional","affiliation":[{"name":"EPPIcenter Program, Division of HIV, ID and Global Medicine, University of California , SanFrancisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Aranda-Diaz","sequence":"additional","affiliation":[{"name":"EPPIcenter Program, Division of HIV, ID and Global Medicine, University of California , SanFrancisco, California ,","place":["USA"]},{"name":"ISGlobal, Hospital Cl\u00ednic \u2013 Universitat de Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meklit","family":"Shiferaw","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matiwos Kidane","family":"Ayele","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fikregabrail Aberra","family":"Kassa","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagim Hailegebrel","family":"Lakew","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanuel","family":"Shimelash","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betelhem Akililu","family":"Kebede","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melat","family":"Abdo","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Migbaru Keffale","family":"Bezabih","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]},{"name":"Department of Medical Microbiology, Radboud University Medical Centre , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya Osman","family":"Moussa","sequence":"additional","affiliation":[{"name":"Clinical Biology Department, Police Health Service , Djibouti, Republic of \u00a0","place":["Djibouti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4103-5029","authenticated-orcid":false,"given":"Tesfaye Sisay","family":"Tessema","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Addis Ababa University , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Greenhouse","sequence":"additional","affiliation":[{"name":"EPPIcenter Program, Division of HIV, ID and Global Medicine, University of California , SanFrancisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdoulilah Ahmed","family":"Abdi","sequence":"additional","affiliation":[{"name":"Presidency Health Council, Djibouti Armed Forces Health Services , Djibouti, Republic of \u00a0","place":["Djibouti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouh Abdi","family":"Khaireh","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre Le Paludisme, Direction des Programmes de Sant\u00e9 Prioritaires, Minist\u00e8re de La Sant\u00e9 , Djibouti, Republic of \u00a0","place":["Djibouti"]},{"name":"Ministry of Health, Global Fund to Fight AIDS, TB, Malaria , Djibouti, Republic of \u00a0","place":["Djibouti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1931-1442","authenticated-orcid":false,"given":"Fitsum G","family":"Tadesse","sequence":"additional","affiliation":[{"name":"Malaria and NTD Division, Armauer Hansen Research Institute , Addis Ababa ,","place":["Ethiopia"]},{"name":"Department of Medical Microbiology, Radboud University Medical Centre , Nijmegen ,","place":["The Netherlands"]},{"name":"Department of Infection Biology, London School of Hygiene and Tropical Medicine , London ,","place":["UK"]},{"name":"Malaria Centre, London School of Hygiene & Tropical Medicine , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"2026061212064687400_ofag324-B1","volume-title":"World health statistics monitoring health for the SDGs, sustainable development goals","author":"World Health Organization","year":"2024"},{"key":"2026061212064687400_ofag324-B2","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.3201\/eid2706.204557","article-title":"Role of anopheles stephensi mosquitoes in malaria outbreak, Djibouti, 2019","volume":"27","author":"de Santi","year":"2021","journal-title":"Emerg Infect Dis"},{"key":"2026061212064687400_ofag324-B3","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s00436-019-06213-0","article-title":"Five years following first detection of anopheles stephensi (Diptera: Culicidae) in Djibouti, Horn of Africa: populations established\u2014malaria emerging","volume":"118","author":"Seyfarth","year":"2019","journal-title":"Parasitol Res"},{"key":"2026061212064687400_ofag324-B4","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.actatropica.2014.06.016","article-title":"First record of the Asian malaria vector anopheles stephensi and its possible role in the resurgence of malaria in Djibouti, Horn of Africa","volume":"139","author":"Faulde","year":"2014","journal-title":"Acta Trop"},{"key":"2026061212064687400_ofag324-B5","volume-title":"World malaria report","author":"World Health Organization","year":"2022"},{"key":"2026061212064687400_ofag324-B6"},{"key":"2026061212064687400_ofag324-B7","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1080\/22221751.2020.1815590","article-title":"Misdiagnosis of imported falciparum malaria from African areas due to an increased prevalence of pfhrp2\/pfhrp3 gene deletion: the Djibouti case","volume":"9","author":"Iriart","year":"2020","journal-title":"Emerg Microbes Infect"},{"key":"2026061212064687400_ofag324-B8","doi-asserted-by":"crossref","first-page":"262","DOI":"10.3390\/diagnostics14030262","article-title":"Assessment of the performance of lactate dehydrogenase-based rapid diagnostic test for malaria in Djibouti in 2022\u20132023","volume":"14","author":"Abdi Moussa","year":"2024","journal-title":"Diagnostics"},{"key":"2026061212064687400_ofag324-B9","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/S1473-3099(21)00142-0","article-title":"Association of Plasmodium falciparum kelch13 R561H genotypes with delayed parasite clearance in Rwanda: an open-label, single-arm, multicentre, therapeutic efficacy study","volume":"21","author":"Uwimana","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"2026061212064687400_ofag324-B10","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1038\/s41564-023-01461-4","article-title":"Plasmodium falciparum resistant to artemisinin and diagnostics have emerged in Ethiopia","volume":"8","author":"Fola","year":"2023","journal-title":"Nat Microbiol"},{"key":"2026061212064687400_ofag324-B11","doi-asserted-by":"crossref","first-page":"100930","DOI":"10.1016\/S2666-5247(24)00172-1","article-title":"The spread of molecular markers of artemisinin partial resistance and diagnostic evasion in Eritrea: a retrospective molecular epidemiology study","volume":"6","author":"Mihreteab","year":"2025","journal-title":"Lancet Microbe"},{"key":"2026061212064687400_ofag324-B12","doi-asserted-by":"crossref","first-page":"554","DOI":"10.4269\/ajtmh.2011.11-0122","article-title":"Malaria in the Republic of Djibouti, 1998\u20132009","volume":"85","author":"Ollivier","year":"2011","journal-title":"Am J Trop Med Hyg"},{"key":"2026061212064687400_ofag324-B13","author":"Schapira","year":"2019"},{"key":"2026061212064687400_ofag324-B14","volume-title":"Assessment and monitoring of antimalarial drug efficacy for the treatment of uncomplicated falciparium malaria","author":"Bloland","year":"2003"},{"key":"2026061212064687400_ofag324-B15","author":"World Health Organization"},{"key":"2026061212064687400_ofag324-B16","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/S0166-6851(01)00379-6","article-title":"Detection of Plasmodium falciparum malaria parasites in vivo by real-time quantitative PCR","volume":"118","author":"Hermsen","year":"2001","journal-title":"Mol Biochem Parasitol"},{"key":"2026061212064687400_ofag324-B17","doi-asserted-by":"crossref","first-page":"10737","DOI":"10.1038\/s41598-025-94716-5","article-title":"Sensitive and modular amplicon sequencing of Plasmodium falciparum diversity and resistance for research and public health","volume":"15","author":"Aranda-D\u00edaz","year":"2025","journal-title":"Sci Rep"},{"key":"2026061212064687400_ofag324-B18","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/1475-2875-8-78","article-title":"Optimization and validation of multi-coloured capillary electrophoresis for genotyping of Plasmodium falciparum merozoite surface proteins (msp1 and 2)","volume":"8","author":"Liljander","year":"2009","journal-title":"Malar J"},{"key":"2026061212064687400_ofag324-B19","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S0035-9203(99)90120-7","article-title":"Biased distribution of msp1 and msp2 allelic variants in Plasmodium falciparum populations in Thailand","volume":"93","author":"Snounou","year":"1999","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2026061212064687400_ofag324-B20","doi-asserted-by":"crossref","first-page":"iyac126","DOI":"10.1093\/genetics\/iyac126","article-title":"Dcifer: an IBD-based method to calculate genetic distance between polyclonal infections","volume":"222","author":"Gerlovina","year":"2022","journal-title":"Genetics"},{"key":"2026061212064687400_ofag324-B21","doi-asserted-by":"crossref","first-page":"btae619","DOI":"10.1093\/bioinformatics\/btae619","article-title":"MOIRE: a software package for the estimation of allele frequencies and effective multiplicity of infection from polyallelic data","volume":"40","author":"Murphy","year":"2024","journal-title":"Bioinformatics"},{"key":"2026061212064687400_ofag324-B22","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/tmi.12847","article-title":"Efficacy of artesunate + sulphadoxine\/pyrimethamine and artemether + lumefantrine and dhfr and dhps mutations in Somalia: evidence for updating the malaria treatment policy","volume":"22","author":"Warsame","year":"2017","journal-title":"Trop Med Int Health"},{"key":"2026061212064687400_ofag324-B23","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1186\/s12936-024-04991-2","article-title":"Therapeutic efficacy and safety of artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria treatment in Metehara, Central-east Ethiopia","volume":"23","author":"Tesfaye","year":"2024","journal-title":"Malar J"},{"key":"2026061212064687400_ofag324-B24","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1056\/NEJMoa2101746","article-title":"Evidence of artemisinin-resistant malaria in Africa","volume":"385","author":"Balikagala","year":"2021","journal-title":"N Engl J Med"},{"key":"2026061212064687400_ofag324-B25","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1590\/0074-0276130274","article-title":"Genetics of chloroquine-resistant malaria: a haplotypic view","volume":"108","author":"Awasthi","year":"2013","journal-title":"Mem Inst Oswaldo Cruz"},{"key":"2026061212064687400_ofag324-B26","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1086\/504269","article-title":"Occurrence of the southeast Asian\/south American SVMNT haplotype of the chloroquine-resistance transporter gene in Plasmodium falciparum in Tanzania","volume":"193","author":"Alifrangis","year":"2006","journal-title":"J Infect Dis"},{"key":"2026061212064687400_ofag324-B27","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/1475-2875-9-174","article-title":"Plasmodium falciparum isolates from Angola show the StctVMNT haplotype in the pfcrt gene","volume":"9","author":"Gama","year":"2010","journal-title":"Malar J"},{"key":"2026061212064687400_ofag324-B28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1475-2875-13-120","article-title":"High prevalence of pfcrt-CVIET haplotype in isolates from asymptomatic and symptomatic patients in south-central Oromia, Ethiopia","volume":"13","author":"Golassa","year":"2014","journal-title":"Malar J"},{"key":"2026061212064687400_ofag324-B29","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1186\/s12936-025-05248-2","article-title":"Plasmodium falciparum multidrug resistance 1 gene polymorphisms associated with outcomes after anti-malarial treatment","volume":"24","author":"Laird","year":"2025","journal-title":"Malar J"},{"key":"2026061212064687400_ofag324-B30","doi-asserted-by":"crossref","first-page":"e0005806","DOI":"10.1371\/journal.pntd.0005806","article-title":"Transmission dynamics of co-endemic plasmodium vivax and P. falciparum in Ethiopia and prevalence of antimalarial resistant genotypes","volume":"11","author":"Lo","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"2026061212064687400_ofag324-B31","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.2147\/IDR.S236898","article-title":"Trends in molecular markers associated with resistance to sulfadoxine-pyrimethamine (SP) among Plasmodium falciparum isolates on Bioko Island, Equatorial Guinea: 2011\u20132017","volume":"13","author":"Lin","year":"2020","journal-title":"Infect Drug Resist"},{"key":"2026061212064687400_ofag324-B32","doi-asserted-by":"crossref","first-page":"21082","DOI":"10.1038\/s41598-021-00714-8","article-title":"Epidemiology of mutant Plasmodium falciparum parasites lacking histidine-rich protein 2\/3 genes in Eritrea 2 years after switching from HRP2-based RDTs","volume":"11","author":"Mihreteab","year":"2021","journal-title":"Sci Rep"},{"key":"2026061212064687400_ofag324-B33","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1038\/s41564-021-00962-4","article-title":"Plasmodium falciparum is evolving to escape malaria rapid diagnostic tests in Ethiopia","volume":"6","author":"Feleke","year":"2021","journal-title":"Nat Microbiol"},{"key":"2026061212064687400_ofag324-B34","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S1473-3099(12)70198-6","article-title":"Primaquine to prevent transmission of falciparum malaria","volume":"13","author":"White","year":"2013","journal-title":"Lancet Infect Dis"},{"key":"2026061212064687400_ofag324-B35","first-page":"905","article-title":"Setting up an NGS sequencing platform and monitoring molecular markers of anti-malarial drug resistance in Djibouti","volume":"13","author":"Papa Mze","year":"2024","journal-title":"Biology (Basel)"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag324\/68440390\/ofag324.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/6\/ofag324\/68440390\/ofag324.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/6\/ofag324\/68440390\/ofag324.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T16:06:58Z","timestamp":1781280418000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag324\/8699001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag324","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,6]]},"article-number":"ofag324"}}