{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:40:00Z","timestamp":1792510800859,"version":"4.5.0"},"reference-count":40,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100009571","name":"Institut de Veille Sanitaire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009571","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009571","name":"Institut de Veille Sanitaire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009571","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009571","name":"Institut de Veille Sanitaire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009571","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009571","name":"Institut de Veille Sanitaire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009571","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009571","name":"Institut de Veille Sanitaire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009571","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009571","name":"Institut de Veille Sanitaire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009571","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Highly sensitive molecular assays are increasingly used for malaria diagnosis but are not recommended for follow-up, as\n                      <jats:italic toggle=\"yes\">Plasmodium falciparum<\/jats:italic>\n                      DNA detection may persist after effective antimalarial treatment, complicating these tests\u2019 clinical interpretation. The biological basis of this persistence remains poorly defined. We investigated the potential role of gametocytes in the context of treated infections. In a prospective cohort of 100 successfully treated patients, we analyzed 379 blood samples collected up to day 28 (D28) post-treatment. We used quantitative PCR (qPCR) to detect parasite DNA targeting\n                      <jats:italic toggle=\"yes\">PfvarATS<\/jats:italic>\n                      , a mainly asexual-stage marker, and\n                      <jats:italic toggle=\"yes\">18S ribosomal RNA<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">18S rRNA<\/jats:italic>\n                      ), a pan-stage marker. To differentiate residual nucleic acid detection from ongoing parasite transcriptional activity among patients\u2019 samples that remained DNA-positive at D28, we used RT-qPCR targeting\n                      <jats:italic toggle=\"yes\">PfvarATS<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">18S rRNA<\/jats:italic>\n                      , and gametocyte-specific transcripts (\n                      <jats:italic toggle=\"yes\">PfAP2-G<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Pfs16<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">PfMGET<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">PfCCP4<\/jats:italic>\n                      ). After anti-malarial treatment, 61% of samples remained qPCR positive at D28.\n                      <jats:italic toggle=\"yes\">PfvarATS<\/jats:italic>\n                      transcripts declined sharply (12% positivity rate at D28), while\n                      <jats:italic toggle=\"yes\">18S rRNA<\/jats:italic>\n                      transcripts persisted longer (60% at D28). Gametocyte-specific markers were detected in a subset:\n                      <jats:italic toggle=\"yes\">Pfs16<\/jats:italic>\n                      (immature stages) was frequent early (100% at D0 and 94% at D3), while mature gametocyte markers (\n                      <jats:italic toggle=\"yes\">PfCCP4\/PfMGET<\/jats:italic>\n                      ) peaked at D7 (33%) and were still detectable in 12% of samples at D28. Therefore, most D28 PCR positivity (88%) occurred without detectable mature gametocyte transcripts. Persistent\n                      <jats:italic toggle=\"yes\">P. falciparum<\/jats:italic>\n                      DNA detection post-treatment in a non-endemic setting predominantly reflects non-viable parasites or residual genetic material and a minority of circulating mature gametocytes. This highlights a key diagnostic pitfall: post-treatment PCR positivity does not equate to treatment failure. Results must be interpreted with clinical context, timing, and assay targets.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        This study confirmed that persistent\n                        <jats:italic toggle=\"yes\">P. falciparum<\/jats:italic>\n                        DNA detection after effective antimalarial treatment mainly reflects residual parasite material, challenging the use of PCR in treatment efficacy follow-up. By excluding mature gametocytes as the primary source of persistent DNA detection, this study advances our understanding of post-treatment parasite nucleic acid kinetics in the organism and supports the importance of investigating alternative biological mechanisms.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02312-26","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:53:21Z","timestamp":1788368001000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Persistence of\n                    <i>Plasmodium falciparum<\/i>\n                    DNA detection after antimalarial treatment and the implication of gametocytes: a prospective cohort study in a non-endemic setting"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8270-7319","authenticated-orcid":true,"given":"Azza","family":"Bouzayene","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05f82e368","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 Paris Cit\u00e9, IRD, Inserm, MERIT","place":["Paris, France"]},{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, AP-HP, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-5388","authenticated-orcid":true,"given":"Valentin","family":"Joste","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, AP-HP, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]},{"name":"Service de parasitologie et mycologie, AP-HP-, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]},{"id":[{"id":"https:\/\/ror.org\/0495fxg12","id-type":"ROR","asserted-by":"publisher"}],"name":"\u00c9quipe Rate, Infections et Parasites, Institut Pasteur","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Candau","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, AP-HP, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]},{"name":"Service de parasitologie et mycologie, AP-HP-, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizwana","family":"Zaffaroullah","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, AP-HP, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Sarrasin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05f82e368","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 Paris Cit\u00e9, IRD, Inserm, MERIT","place":["Paris, France"]},{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, AP-HP, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0458-2664","authenticated-orcid":true,"given":"Nicolas","family":"Argy","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05f82e368","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 Paris Cit\u00e9, IRD, Inserm, MERIT","place":["Paris, France"]},{"name":"Service de parasitologie et mycologie, AP-HP-, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6914-7957","authenticated-orcid":true,"given":"Sandrine","family":"Cojean","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, AP-HP, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]},{"id":[{"id":"https:\/\/ror.org\/03xjwb503","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 Paris-Saclay","place":["Gif-sur-Yvette, France"]},{"name":"UMR BIPAR, Animal Health Laboratory, ANSES, INRAE, \u00c9cole Nationale V\u00e9t\u00e9rinaire d'Alfort, Universit\u00e9 Paris-Est","place":["Maisons-Alfort, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9016-3847","authenticated-orcid":true,"given":"Sandrine","family":"Houz\u00e9","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05f82e368","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 Paris Cit\u00e9, IRD, Inserm, MERIT","place":["Paris, France"]},{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, AP-HP, H\u00f4pital Bichat Claude Bernard","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","unstructured":"World malaria report. 2025. 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