{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T20:43:04Z","timestamp":1772311384635,"version":"3.50.1"},"reference-count":46,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Global Infectious Disease Institute"},{"name":"Center for Global Health Equity"},{"DOI":"10.13039\/501100001871","name":"Fundacao para a Ciencia e a Tecnologia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Instituto Camoes Bolsas Camoes"},{"name":"Fundacao Millennium BCP"},{"name":"Paroquia de Sao Nicolau-Lisboa"},{"name":"HHS | National Institutes of Health","award":["R01AI150856"],"award-info":[{"award-number":["R01AI150856"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2024,7,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              While the\n              <jats:italic>Plasmodium falciparum<\/jats:italic>\n              malaria parasite continues to cause severe disease globally, Mozambique is disproportionally represented in malaria case totals. Acquisition of copy number variations (CNVs) in the parasite genome contributes to antimalarial drug resistance through overexpression of drug targets. Of interest, piperaquine resistance is associated with plasmepsin 2 and 3 CNVs (\n              <jats:italic>pfpmp2<\/jats:italic>\n              and\n              <jats:italic>pfpmp3,<\/jats:italic>\n              respectively), while CNVs in the multidrug efflux pump, multidrug resistance-1 (\n              <jats:italic>pfmdr1<\/jats:italic>\n              ), increase resistance to amodiaquine and lumefantrine. These antimalarials are partner drugs in artemisinin combination therapies (ACTs) and therefore, CNV detection with accurate and efficient tools is necessary to track ACT resistance risk. Here, we evaluated ~300 clinically derived samples collected from three sites in Mozambique for resistance-associated CNVs. We developed a novel, medium-throughput, quadruplex droplet digital PCR (ddPCR) assay to simultaneously quantify the copy number of\n              <jats:italic>pfpmp3, pfpmp2<\/jats:italic>\n              , and\n              <jats:italic>pfmdr1<\/jats:italic>\n              loci in these clinical samples. By using DNA from laboratory parasite lines, we show that this nanodroplet-based method is capable of detecting picogram levels of parasite DNA, which facilitates its application for low yield and human host-contaminated clinical surveillance samples. Following ddPCR and the application of quality control standards, we detected CNVs in 13 of 229 high-quality samples (prevalence of 5.7%). Overall, our study revealed a low number of resistance CNVs present in the parasite population across all three collection sites, including various combinations of\n              <jats:italic>pfmdr1<\/jats:italic>\n              ,\n              <jats:italic>pfpmp2<\/jats:italic>\n              , and\n              <jats:italic>pfpmp3<\/jats:italic>\n              CNVs. The potential for future ACT resistance across Mozambique emphasizes the need for continued molecular surveillance across the region.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aac.00346-24","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T13:02:15Z","timestamp":1716296535000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":9,"title":["Antimalarial resistance risk in Mozambique detected by a novel quadruplex droplet digital PCR assay"],"prefix":"10.1128","volume":"68","author":[{"given":"Noah","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Biology, University of Virginia, Charlottesville, Virginia, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2083-2579","authenticated-orcid":false,"given":"Clemente","family":"da Silva","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal"}]},{"given":"Caroline","family":"Webb","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Virginia, Charlottesville, Virginia, USA"}]},{"given":"Daniela","family":"Matias","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal"}]},{"given":"Brigite","family":"Dias","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal"}]},{"given":"Beatriz","family":"Cancio","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal"}]},{"given":"Miguel","family":"Silva","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal"}]},{"given":"Ruben","family":"Viegas","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal"}]},{"given":"Crizolgo","family":"Salvador","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade, Maputo (INS), Maputo, Mozambique"}]},{"given":"Nordino","family":"Chivale","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade, Maputo (INS), Maputo, Mozambique"}]},{"given":"Sonia","family":"Luis","sequence":"additional","affiliation":[{"name":"Hospital Provincial de Matola, Matola, Mozambique"}]},{"given":"Paulo","family":"Arnaldo","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade, Maputo (INS), Maputo, Mozambique"}]},{"given":"Julia","family":"Zulawinska","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Virginia, Charlottesville, Virginia, USA"}]},{"given":"Christopher C.","family":"Moore","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease and International Health, University of Virginia, Charlottesville, Virginia, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0313-0778","authenticated-orcid":false,"given":"Fatima","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6301-4563","authenticated-orcid":true,"given":"Jennifer L.","family":"Guler","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Virginia, Charlottesville, Virginia, USA"},{"name":"Division of Infectious Disease and International Health, University of Virginia, Charlottesville, Virginia, USA"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40101-021-00254-0"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-6-121"},{"key":"e_1_3_4_6_2","unstructured":"MISAU. 2017. Normas de tratamento DA Mal\u00e1ria em Mo\u00e7ambique p 82. 3rd ed. MISAU editor. 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