{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T04:16:31Z","timestamp":1780805791859,"version":"3.54.1"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R25TW011213"],"award-info":[{"award-number":["1R25TW011213"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["TMA2019CDF-2662-Pfkelch13"],"award-info":[{"award-number":["TMA2019CDF-2662-Pfkelch13"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>CYP2B6<jats:italic>,<\/jats:italic> one of the most polymorphic enzymes, plays a major role in the metabolism of artemisinin and its derivatives. Variation in the frequency of the most common, yet functionally deficient <jats:italic>CYP2B6*6<\/jats:italic> allele may impact artemisinin exposure, potentially contributing to differences in treatment outcomes<jats:italic>.<\/jats:italic> This study assessed the prevalence of the <jats:italic>CYP2B6*6<\/jats:italic> genotype among patients with uncomplicated malaria treated with artemether-lumefantrine at Adjumani District Hospital in the West Nile region, Uganda. A total of 100 randomly selected patients with microscopically confirmed uncomplicated <jats:italic><jats:italic>P. falciparum<\/jats:italic><\/jats:italic> malaria receiving artemether-lumefantrine (AL) were included in the study. Blood samples, 2\u22123\u2009mL each, were collected using EDTA tubes on days 0 and 3 after AL administration. DNA was extracted using Qiagen DNA Mini kit. Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) was used to determine the <jats:italic>CYP2B6*6<\/jats:italic> genotype of the participants. <jats:italic><jats:italic>P. falciparum<\/jats:italic><\/jats:italic> positivity was determined by microscopy and qPCR. For qPCR, parasite clearance was determined using comparative CT value. Data analysis was done using STATA <jats:italic><jats:italic>ver<\/jats:italic><\/jats:italic> 17.0 at a 95% significance level. Among the malaria patients genotyped, 65% were female, and 35% were male, with a mean age of 17\u2009\u00b1\u200910 years. The <jats:italic>CYP2B6*6<\/jats:italic> variant allele frequency was 0.37, and the genotype frequency was 43% GG, 17% TT and 40% GT. <jats:italic><jats:italic>P. falciparum<\/jats:italic><\/jats:italic> day 3 microscopy positivity was 14% (6\/43) among the GG, 37.5% (15\/40) among the GT, and 17.64% (3\/17) among the TT patients. PCR positivity rates were 58.1% (25\/43) in the GG, 72.5% (29\/40) in the GT, and 52.9% (9\/17) in the TT patients. Heterozygous individuals (GT) had slow parasite clearance by a 10-fold difference compared to the homozygous (GG, TT) individuals (<jats:italic><jats:italic>U<\/jats:italic><\/jats:italic>\u2009=\u2009323.0; <jats:italic><jats:italic>Z<\/jats:italic><\/jats:italic>\u2009=\u2009\u22122.3442; <jats:italic><jats:italic>p<\/jats:italic><\/jats:italic>\u2009=\u20090.019). Malaria patients in Adjumani district had a high frequency of the <jats:italic>CYP2B6*6<\/jats:italic> variant allele. Interindividual variability in <jats:italic><jats:italic>P. falciparum<\/jats:italic><\/jats:italic> clearance exists, with heterozygous patients demonstrating slow artemether-lumefantrine <jats:italic><jats:italic>P. falciparum<\/jats:italic><\/jats:italic> parasite clearance. There is a need to consider incorporating host genomic factors, such as metabolising enzyme genotype into routine Therapeutic Efficacy Studies (TES).<\/jats:p>","DOI":"10.1371\/journal.pone.0322918","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T17:51:32Z","timestamp":1754070692000},"page":"e0322918","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["CYP2B6*6 single nucleotide polymorphism among patients with uncomplicated malaria in Adjumani district, Uganda: Implications on efficacy of artemether-lumefantrine"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1211-7762","authenticated-orcid":true,"given":"Martin Kamilo","family":"Angwe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah","family":"Mwebaza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam Lubwama","family":"Nsobya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Kiguba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Vudriko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saviour","family":"Dralabu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6557-8928","authenticated-orcid":true,"given":"Denis","family":"Omali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Agnes","family":"Tumwebaze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8852-820X","authenticated-orcid":true,"given":"Moses","family":"Ocan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"pone.0322918.ref001","unstructured":"World Health Organization. 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