{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T07:11:04Z","timestamp":1779347464822,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":139,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020473","name":"Badan Riset dan Inovasi Nasional","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020473","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["TSA 203033242"],"award-info":[{"award-number":["TSA 203033242"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Parasitology Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    The efficacy of antimalarial treatment, particularly artemisinin\u2010based combination therapy (ACT), continues to face persistent threats due to the development of drug resistance in\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    . Although artemisinin derivatives remain effective, ACT regimen failure often results from decreased efficacy of the companion drug. Therefore, robust molecular surveillance focusing on genetic markers associated with companion drug resistance is essential to maintain global efficacy. The combination of dihydroartemisinin\u2013piperaquine (DHA\u2010PPQ) has long been used as first\u2010line therapy and has proven effective; however, reports of resistance to piperaquine (PPQ) in Southeast Asia are cause for concern. The study is aimed at evaluating copy number variation (CNV) of the\n                    <jats:italic>Plasmodium falciparum multidrug resistance-1<\/jats:italic>\n                    (\n                    <jats:italic>Pfmdr1<\/jats:italic>\n                    ) gene as part of a descriptive molecular surveillance approach in East Nusa Tenggara, Indonesia. A total of 41 dried blood spot (DBS) samples from patients with\n                    <jats:italic>falciparum<\/jats:italic>\n                    malaria treated with DHA\u2010PPQ were analyzed. The DNA extraction was performed using the QIAamp DNA Mini Kit, and CNV of the\n                    <jats:italic>Pfmdr1<\/jats:italic>\n                    gene was determined by real\u2010time PCR. The phenotypes of all 41 patients showed a good treatment response, with 100% adequate clinical and parasitological response (ACPR) on Day 42. Analysis of the\n                    <jats:italic>Pfmdr1<\/jats:italic>\n                    gene CNV identified 36 isolates (87.81%) with\n                    <jats:italic>a single copy<\/jats:italic>\n                    and 5 isolates (12.19%) with\n                    <jats:italic>multiple copies.<\/jats:italic>\n                    These findings indicate genetic variation related to selective pressure against PPQ. While DHA\u2010PPQ remains clinically effective in East Nusa Tenggara for now, the presence of these genetic markers necessitates a proactive surveillance strategy to detect shifts in drug sensitivity before widespread clinical failure occurs.\n                  <\/jats:p>","DOI":"10.1155\/japr\/1352732","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T06:44:20Z","timestamp":1779345860000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of\n                    <i>pfmdr1<\/i>\n                    Gene Copy Number on the Efficacy of Dihydroartemisinin\u2013Piperaquine in Treating Malaria in West Sumba and Kupang Districts, East Nusa Tenggara, Indonesia"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1403-5266","authenticated-orcid":false,"given":"Irdayanti","family":"Irdayanti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4432-1153","authenticated-orcid":false,"given":"Hijral","family":"Aswad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4582-9133","authenticated-orcid":false,"given":"Puji B. 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Made","family":"Artika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7141-2545","authenticated-orcid":false,"given":"Din","family":"Syafruddin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_10_1_2","unstructured":"Indonesian Ministry of Health Malaria Cases in Indonesia 2025 https:\/\/malaria.kemkes.go.id\/case."},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.17-0662"},{"key":"e_1_2_10_3_2","unstructured":"Indonesian Ministry of Health Annual Malaria Report Directorate of P2P 2022 2022 https:\/\/malaria.kemkes.go.id\/sites\/default\/files\/2023-11\/Annual%20Malaria%20Report%202022_English%20version%20%281%29.pdf."},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2408.170768"},{"key":"e_1_2_10_5_2","unstructured":"World Health Organization Antimalarial Drug Combination Therapy. Report of a WHO Technical Consultation 2021 2025 https:\/\/iris.who.int\/bitstream\/handle\/10665\/66952\/WHO_CDS_RBM_2001.3.pdf."},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00686-12"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30409-1"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30048-8"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30415-7"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1097-2765(05)00077-8"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.06350-11"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1051\/bioconf\/202518401018"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02655-16"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-023-04658-4"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-5-1"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1086\/507115"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.43.12.2943"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.91.3.1143"},{"key":"e_1_2_10_19_2","volume-title":"Genetic Analysis of Malaria Parasite Isolates From Southwest Sumba and Keerom Districts, Indonesia","author":"Rahmasari F. 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