{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:18:01Z","timestamp":1784071081092,"version":"3.55.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The development of resistance by <jats:italic>Plasmodium falciparum<\/jats:italic> to anti-malarial drugs impedes any benefits of the drug. In addition, absence or delayed availability of current anti-malarial drugs in remote areas has the potential to results to parasite escape and continuous transmission.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>The case of a 29-year old pregnant woman from Biase Local Government Area in Cross River State Nigeria presenting with febrile illness and high body temperature of 38.7\u00a0\u00b0C was reported. She looked pale and vomited twice on arrival at the\u00a0health facility. Her blood smear on the first day of hospitalization was positive for <jats:italic>P. falciparum<\/jats:italic> by RDT, microscopy (21,960 parasite\/\u00b5l) and real-time PCR, with a PCV of 18%. She was treated with 600\u00a0mg intravenous quinine in 500 ml of 5% Dextrose\/0.9% Saline 8-hourly for 24\u00a0h. On the second day of hospitalization, she complained of weakness, persistent high-grade fever and vaginal bleeding. A bulging amnion from an extended cervix was observed. Following venous blood collection for laboratory investigations, 600\u00a0\u00b5g of misoprostol was inserted into the posterior fornix of her vagina as part of her obstetric care. Parenteral quinine was discontinued, and she was given full therapeutic regimen of artemether-lumefantrine 80\/480\u00a0mg tablets to be taken for 3 days beginning from the second day. Her blood samples on the second and third day of hospitalization remained positive for <jats:italic>P. falciparum<\/jats:italic> by all three diagnostic methods. Single nucleotide polymorphism (SNP) assay on all three <jats:italic>P. falciparum<\/jats:italic> isolates revealed the presence of variants associated with multiple drug resistant markers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>Infecting <jats:italic>P. falciparum<\/jats:italic> isolates may have been resistant to initial quinine treatment resulting from parasite cross-resistance with other quinoline associated resistant markers such as 86Y and 184\u00a0F.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Therefore, the likely transmission of similarly resistant parasites in the study area calls for reinforcement of interventions and adherence to current World Health Organization guidelines in administering only approved drugs to individuals in order to mitigate parasite escape and eventual transmission to other susceptible individuals.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-022-04176-9","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T09:04:25Z","timestamp":1654247065000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multiple Plasmodium falciparum drug resistance polymorphisms identified in a pregnant woman with severe malaria and a concomitant spontaneous abortion in Cross River, Nigeria, West Africa"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5720-8425","authenticated-orcid":false,"given":"Mary Aigbiremo","family":"Oboh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatou","family":"Faal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwagbemisola Elizabeth","family":"Adeniji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Correa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Uyimulam","family":"Amawu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekon","family":"Ogban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Heinz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M.","family":"Meremikwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Amambua-Ngwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"4176_CR1","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1186\/1475-2875-13-271","volume":"13","author":"V Moya-Alvarez","year":"2014","unstructured":"Moya-Alvarez V, Abellana R, Cot M. Pregnancy-associated malaria and malaria in infants: an old problem with present consequences. Malar J. 2014;13:271.","journal-title":"Malar J"},{"key":"4176_CR2","volume-title":"World malaria report 2020","author":"WHO","year":"2020","unstructured":"WHO. World malaria report 2020. Geneva: World Health Organization; 2020."},{"issue":"Suppl 6","key":"4176_CR3","doi-asserted-by":"publisher","first-page":"14","DOI":"10.4269\/ajtmh.77.6.suppl.14","volume":"77","author":"SJ Rogerson","year":"2007","unstructured":"Rogerson SJ, Mwapasa V, Meshnick SR. Malaria in pregnancy: linking immunity and pathogenesis to prevention. Am J Trop Med Hyg. 2007;77(Suppl 6):14\u201322.","journal-title":"Am J Trop Med Hyg"},{"key":"4176_CR4","volume-title":"The risk and severity of malaria in pregnant women","author":"B Brabin","year":"1991","unstructured":"Brabin B. The risk and severity of malaria in pregnant women. 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