{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T20:12:44Z","timestamp":1779048764462,"version":"3.51.4"},"reference-count":97,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T00:00:00Z","timestamp":1607299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["Wellcome Trust [DELGEME Grant #107740\/Z\/15\/Z]"],"award-info":[{"award-number":["Wellcome Trust [DELGEME Grant #107740\/Z\/15\/Z]"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01A1099527"],"award-info":[{"award-number":["R01A1099527"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Drug resistance remains a concern for malaria control and elimination. The effect of interventions on its prevalence needs to be monitored to pre-empt further selection. We assessed the prevalence of <jats:italic>Plasmodium falciparum<\/jats:italic> gene mutations associated with resistance to the antimalarial drugs: sulfadoxine-pyrimethamine (SP), chloroquine (CQ) and artemisinin combination therapy (ACTs) after the scale-up of a vector control activity that reduced transmission.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 400 <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> isolates from children under five years were genotyped for seventeen single nucleotide polymorphisms (SNPs) in <jats:italic>pfcrt<\/jats:italic>, <jats:italic>pfmdr1<\/jats:italic>, <jats:italic>pfdhfr<\/jats:italic>, <jats:italic>pfdhps<\/jats:italic> and <jats:italic>pfk13<\/jats:italic> genes using polymerase chain reaction (PCR) and high resolution melting (HRM) analysis. These included 80 isolates, each randomly selected from cross-sectional surveys of asymptomatic infections across 2010 (baseline), 2011, 2012, 2013 (midline: post-IRS) and 2014 (endline: post-IRS) during the peak transmission season, when IRS intervention was rolled out in Bunkpurugu Yunyoo (BY) District, Ghana. The proportions of isolates with drug resistant alleles were assessed over this period.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>There were significant decreases in the prevalence of <jats:italic>pfdhfr<\/jats:italic>- I<jats:sub>51<\/jats:sub>R<jats:sub>59<\/jats:sub>N<jats:sub>108<\/jats:sub> haplotype from 2010 to 2014, while the decline in <jats:italic>pfdhfr\/pfdhps-<\/jats:italic> I<jats:sub>51<\/jats:sub>R<jats:sub>59<\/jats:sub>N<jats:sub>108<\/jats:sub>G<jats:sub>437<\/jats:sub> during the same period was not significant. The prevalence of lumefantrine (LM), mefloquine (MQ) and amodiaquine (AQ) resistance-associated haplotypes <jats:italic>pfmdr1<\/jats:italic>-N<jats:sub>86<\/jats:sub>F<jats:sub>184<\/jats:sub>D<jats:sub>1246<\/jats:sub> and <jats:italic>pfmdr1<\/jats:italic>-Y<jats:sub>86<\/jats:sub>Y<jats:sub>184<\/jats:sub>Y<jats:sub>1246<\/jats:sub> showed decreasing trends (z = -2.86, P = 0.004 and z = -2.71, P = 0.007, respectively). Each of <jats:italic>pfcrt-<\/jats:italic>T76 and <jats:italic>pfmdr1<\/jats:italic>-Y86 mutant alleles also showed a declining trend in the asymptomatic reservoir, after the IRS rollout in 2014 (z = -2.87, P = 0.004 and z = -2.65, P = 0.008, respectively). Similarly, Pyrimethamine resistance mediating polymorphisms <jats:italic>pfdhfr<\/jats:italic>-N108, <jats:italic>pfdhfr<\/jats:italic>-I51 and <jats:italic>pfdhfr<\/jats:italic>-R59 also declined (z = -2.03, P = 0.042, z = -3.54, P&lt;0.001 and z = -4.63, P&lt;0.001, respectively), but not the sulphadoxine resistance mediating <jats:italic>pfdhps<\/jats:italic>-G437 and <jats:italic>pfdhps<\/jats:italic>-F436 (z = -0.36, P = 0.715 and z = 0.41, P = 0.684, respectively). No mutant <jats:italic>pfk13<\/jats:italic>-Y580 were detected during the study period.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The study demonstrated declining trends in the prevalence of drug resistant mutations in asymptomatic <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> infections following transmission reduction after an enhanced IRS intervention in Northern Ghana.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0233478","type":"journal-article","created":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T23:35:24Z","timestamp":1607384124000},"page":"e0233478","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Assessment of antimalarial drug resistant markers in asymptomatic Plasmodium falciparum infections after 4 years of indoor residual spraying in Northern Ghana"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7125-1673","authenticated-orcid":true,"given":"James L.","family":"Myers-Hansen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Abuaku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1003-2570","authenticated-orcid":true,"given":"Muyiwa K.","family":"Oyebola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedicta A.","family":"Mensah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Collins","family":"Ahorlu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon","family":"Awandare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwadwo A.","family":"Koram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred Amambua","family":"Ngwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4639-1249","authenticated-orcid":true,"given":"Anita","family":"Ghansah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2020,12,7]]},"reference":[{"key":"pone.0233478.ref001","unstructured":"WHO. 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