{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:30:15Z","timestamp":1790314215530,"version":"4.1.0"},"reference-count":43,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2017,11,22]],"date-time":"2017-11-22T00:00:00Z","timestamp":1511308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T00:00:00Z","timestamp":1512086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100000265","name":"RCUK | Medical Research Council","doi-asserted-by":"publisher","award":["MC_EX_MR\/K02440X\/1"],"award-info":[{"award-number":["MC_EX_MR\/K02440X\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Antimalarial interventions have yielded a significant decline in malaria prevalence in The Gambia, where artemether-lumefantrine (AL) has been used as a first-line antimalarial for a decade. Clinical\n            <jats:named-content content-type=\"genus-species\">Plasmodium falciparum<\/jats:named-content>\n            isolates collected from 2012 to 2015 were analyzed\n            <jats:italic>ex vivo<\/jats:italic>\n            for antimalarial susceptibility and genotyped for drug resistance markers (\n            <jats:italic>pfcrt<\/jats:italic>\n            K76T,\n            <jats:italic>pfmdr1<\/jats:italic>\n            codons 86, 184, and 1246, and\n            <jats:italic>pfk13<\/jats:italic>\n            ) and microsatellite variation. Additionally, allele frequencies of single nucleotide polymorphisms (SNPs) from other drug resistance-associated genes were compared from genomic sequence data sets from 2008 (\n            <jats:italic>n<\/jats:italic>\n            = 79) and 2014 (\n            <jats:italic>n<\/jats:italic>\n            = 168). No artemisinin resistance-associated\n            <jats:italic>pfk13<\/jats:italic>\n            mutation was found, and only 4% of the isolates tested in 2015 showed significant growth after exposure to dihydroartemisinin. Conversely, the 50% inhibitory concentrations (IC\n            <jats:sub>50<\/jats:sub>\n            s) of amodiaquine and lumefantrine increased within this period.\n            <jats:italic>pfcrt<\/jats:italic>\n            76T and\n            <jats:italic>pfmdr1<\/jats:italic>\n            184F mutants remained at a prevalence above 80%.\n            <jats:italic>pfcrt<\/jats:italic>\n            76T was positively associated with higher IC\n            <jats:sub>50<\/jats:sub>\n            s to chloroquine.\n            <jats:italic>pfmdr1<\/jats:italic>\n            NYD increased in frequency between 2012 and 2015 due to lumefantrine selection. The TNYD (\n            <jats:italic>pfcrt<\/jats:italic>\n            76T and\n            <jats:italic>pfmdr1<\/jats:italic>\n            NYD wild-type haplotype) also increased in frequency following AL implementation in 2008. These results suggest selection for\n            <jats:italic>pfcrt<\/jats:italic>\n            and\n            <jats:italic>pfmdr1<\/jats:italic>\n            genotypes that enable tolerance to lumefantrine. Increased tolerance to lumefantrine calls for sustained chemotherapeutic monitoring in The Gambia to minimize complete artemisinin combination therapy (ACT) failure in the future.\n          <\/jats:p>","DOI":"10.1128\/aac.00759-17","type":"journal-article","created":{"date-parts":[[2017,10,3]],"date-time":"2017-10-03T00:30:26Z","timestamp":1506990626000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":22,"title":["Sustained\n            <i>Ex Vivo<\/i>\n            Susceptibility of Plasmodium falciparum to Artemisinin Derivatives but Increasing Tolerance to Artemisinin Combination Therapy Partner Quinolines in The Gambia"],"prefix":"10.1128","volume":"61","author":[{"given":"Alfred","family":"Amambua-Ngwa","sequence":"first","affiliation":[{"name":"Medical Research Council Unit The Gambia, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Okebe","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haddijatou","family":"Mbye","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukai","family":"Ceesay","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"El-Fatouri","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatou","family":"Joof","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia, Fajara, The 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