{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:59:14Z","timestamp":1790351954230,"version":"4.1.0"},"reference-count":85,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100014035","name":"Armed Forces Health Surveillance Division","doi-asserted-by":"crossref","award":["ProMIS ID P0185_23_N3\/ P0158_24_N3"],"award-info":[{"award-number":["ProMIS ID P0185_23_N3\/ P0158_24_N3"]}],"id":[{"id":"10.13039\/100014035","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Molecular markers give evidence of\n                      <jats:italic toggle=\"yes\">Plasmodium falciparum<\/jats:italic>\n                      resistance to antimalarials. We determined the spatial and temporal distribution of antimalarial drug resistance markers in the\n                      <jats:italic toggle=\"yes\">P. falciparum<\/jats:italic>\n                      population in Ghana using targeted amplicon deep sequencing. We contextualized our findings within the framework that duration of drug exposure and transmission intensity drive trends in molecular markers. About 87% (901\/1,037) of samples collected from children \u22649 years with uncomplicated malaria from 2018 to 2023 were sequenced. There was a decreasing trend in the amodiaquine\/lumefantrine\n                      <jats:italic toggle=\"yes\">pfmdr1<\/jats:italic>\n                      N\n                      <jats:underline>F<\/jats:underline>\n                      SND haplotype in the Coastal zone. For chloroquine, the\n                      <jats:italic toggle=\"yes\">pfcrt<\/jats:italic>\n                      CV\n                      <jats:underline>IET<\/jats:underline>\n                      haplotype showed a decreasing trend in all zones. For sulfadoxine-pyrimethamine, the\n                      <jats:italic toggle=\"yes\">pfdhps<\/jats:italic>\n                      S\n                      <jats:underline>G<\/jats:underline>\n                      KAA haplotype showed increasing trends in all zones in contrast with the\n                      <jats:italic toggle=\"yes\">pfdhps<\/jats:italic>\n                      <jats:underline>AG<\/jats:underline>\n                      KAA,\n                      <jats:italic toggle=\"yes\">pfdhfr<\/jats:italic>\n                      <jats:underline>IRN<\/jats:underline>\n                      ,\n                      <jats:underline\/>\n                      and quintuple\n                      <jats:underline>IRN + AG<\/jats:underline>\n                      KAA haplotypes. Finally, validated markers of artemisinin resistance P441L (1\/709), M476I (1\/709), N537I (1\/709), A481V (1\/709), P574L (1\/709), C469Y (2\/709), P553L (2\/709), R561H (2\/709), A578S (4\/709), and A675V (5\/709) were identified. Zonal differences in trends for\n                      <jats:italic toggle=\"yes\">pfmdr1<\/jats:italic>\n                      N\n                      <jats:underline>F<\/jats:underline>\n                      SND haplotype are likely due to lower amodiaquine drug pressure in the Coastal zone. Policy review of amodiaquine\/lumefantrine antimalarial use might help reduce the increasing trends seen in the Forest and Savannah zones. The declining prevalence of the\n                      <jats:italic toggle=\"yes\">pfcrt<\/jats:italic>\n                      mutant CV\n                      <jats:underline>IET<\/jats:underline>\n                      after two decades of chloroquine disuse in Ghana suggests the return of chloroquine-sensitive parasites. Therapeutic efficacy studies must be done to verify this observation. The opposing trends of sulfadoxine-pyrimethamine molecular markers highlight concern for its use in malaria prophylaxis in pregnancy and children. Molecular surveillance remains vital to mitigating the risk of artemisinin-resistant parasites evolving in malaria-endemic regions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01902-25","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:25:51Z","timestamp":1778595951000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["Spatial and temporal description of antimalarial drug resistance markers in Ghana using targeted amplicon deep sequencing"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1628-2845","authenticated-orcid":true,"given":"Kwesi Zandoh","family":"Tandoh","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00f1qr933","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of 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