{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:50:15Z","timestamp":1784029815965,"version":"3.55.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T00:00:00Z","timestamp":1669939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>In spite of promising medical, sociological, and engineering strategies and interventions to reduce the burden of disease, malaria remains a source of significant morbidity and mortality, especially among children in sub-Saharan Africa. In particular, progress in the development and administration of chemotherapeutic agents is threatened by evolved resistance to most of the antimalarials currently in use, including artemisinins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study analyzed the prevalence of mutations associated with antimalarial resistance in <jats:italic>Plasmodium falciparum<\/jats:italic> from 95 clinical samples collected from individuals with clinically confirmed malaria at a hospital in Bo, Sierra Leone between May 2017 and December 2018. The combination of polymerase chain reaction amplification and subsequent high throughput DNA sequencing was used to determine the presence of resistance-associated mutations in five <jats:italic>P. falciparum<\/jats:italic> genes \u2013 <jats:italic>pfcrt, pfmdr1, pfdhfr, pfdhps<\/jats:italic> and <jats:italic>pfkelch13<\/jats:italic>. The geographic origin of parasites was assigned using mitochondrial sequences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Relevant mutations were detected in the <jats:italic>pfcrt<\/jats:italic> (22%), <jats:italic>pfmdr1<\/jats:italic> (&amp;gt;58%), <jats:italic>pfdhfr<\/jats:italic> (100%) and <jats:italic>pfdhps<\/jats:italic> (&amp;gt;80%) genes while no resistance-associated mutations were found in the <jats:italic>pfkelch13<\/jats:italic> gene. The mitochondrial barcodes were consistent with a West African parasite origin with one exception indicating an isolate imported from East Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Detection of the <jats:italic>pfmdr1<\/jats:italic> NFSND haplotype in 50% of the samples indicated the increasing prevalence of strains with elevated tolerance to artemeter + lumefantrine (AL) threatening the combination currently used to treat uncomplicated malaria in Sierra Leone. The frequency of mutations linked to resistance to antifolates suggests widespread resistance to the drug combination used for intermittent preventive treatment during pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2022.1059695","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T10:03:55Z","timestamp":1669975435000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of malaria resistance-associated mutations in Plasmodium falciparum circulating in 2017\u20132018, Bo, Sierra Leone"],"prefix":"10.3389","volume":"13","author":[{"given":"Tomasz A.","family":"Leski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris Rowe","family":"Taitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie M.","family":"Colston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umaru","family":"Bangura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Holtz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadwick Y.","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathanael D.","family":"Reynolds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Lahai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Lamin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Baio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashid","family":"Ansumana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Stenger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary J.","family":"Vora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1186\/s13104-019-4269-1","article-title":"High prevalence of Pfmdr-1 N86 and D1246 genotypes detected among febrile malaria outpatients attending lira regional referral hospital, northern Uganda.","volume":"12","author":"Achol","year":"2019","journal-title":"BMC Res. Notes"},{"key":"B2","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/S1473-3099(16)30409-1","article-title":"Genetic markers associated with dihydroartemisinin-piperaquine failure in Plasmodium falciparum malaria in Cambodia: A genotype-phenotype association study.","volume":"17","author":"Amato","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/nature12876","article-title":"A molecular marker of artemisinin-resistant Plasmodium falciparum malaria.","volume":"505","author":"Ariey","year":"2014","journal-title":"Nature"},{"key":"B4","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.ijpddr.2020.11.006","article-title":"Artemisinin-based combination therapy (ACT) and drug resistance molecular markers: A systematic review of clinical studies from two malaria endemic regions \u2013 India and Sub-Saharan Africa.","volume":"15","author":"Arya","year":"2021","journal-title":"Int. J. Parasitol. Drugs Drug Resist."},{"key":"B5","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1056\/NEJMoa1314981","article-title":"Spread of artemisinin resistance in Plasmodium falciparum malaria.","volume":"371","author":"Ashley","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1056\/NEJMoa2101746","article-title":"Evidence of artemisinin-resistant malaria in Africa.","volume":"385","author":"Balikagala","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"271","DOI":"10.4269\/ajtmh.2000.62.271","article-title":"Molecular epidemiology of malaria in Yaounde, Cameroon. VI. Sequence variations in the Plasmodium falciparum dihydrofolate reductase-thymidylate synthase gene and in vitro resistance to pyrimethamine and cycloguanil.","volume":"62","author":"Basco","year":"2000","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.molbiopara.2007.01.018","article-title":"Plasmodium falciparum Na+\/H+ exchanger activity and quinine resistance.","volume":"153","author":"Bennett","year":"2007","journal-title":"Mol. Biochem. Parasitol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1038\/nm.4381","article-title":"Antimalarial drug resistance: Linking Plasmodium falciparum parasite biology to the clinic.","volume":"23","author":"Blasco","year":"2017","journal-title":"Nat. Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1186\/s12936-015-0909-7","article-title":"Lack of effect of intermittent preventive treatment for malaria in pregnancy and intense drug resistance in western Uganda.","volume":"14","author":"Braun","year":"2015","journal-title":"Malar. J."},{"key":"B11","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1086\/648594","article-title":"Susceptibility of Plasmodium falciparum isolates to doxycycline is associated with pftetQ sequence polymorphisms and pftetQ and pfmdt copy numbers.","volume":"201","author":"Briolant","year":"2010","journal-title":"J. Infect. Dis."},{"key":"B12","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/s0001-706x(02)00264-4","article-title":"High prevalence of quintuple mutant dhps\/dhfr genes in Plasmodium falciparum infections seven years after introduction of sulfadoxine and pyrimethamine as first line treatment in Malawi.","volume":"85","author":"Bwijo","year":"2003","journal-title":"Acta Trop."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e114","DOI":"10.1016\/S2214-109X(21)00459-9","article-title":"Child, maternal, and adult mortality in Sierra Leone: Nationally representative mortality survey 2018-20.","volume":"10","author":"Carshon-Marsh","year":"2022","journal-title":"Lancet Glob. Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e338","DOI":"10.1016\/S1473-3099(19)30261-0","article-title":"Antimalarial drug resistance in Africa: The calm before the storm?","volume":"19","author":"Conrad","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1073\/pnas.91.3.1143","article-title":"Selection for mefloquine resistance in Plasmodium falciparum is linked to amplification of the pfmdr1 gene and cross-resistance to halofantrine and quinine.","volume":"91","author":"Cowman","year":"1994","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"B16","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1111\/j.1365-2958.2012.08180.x","article-title":"Mechanisms of in vitro resistance to dihydroartemisinin in Plasmodium falciparum.","volume":"86","author":"Cui","year":"2012","journal-title":"Mol. Microbiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1086\/606009","article-title":"Plasmodium falciparum multidrug resistance protein 1 and artemisinin-based combination therapy in Africa.","volume":"200","author":"Dahlstrom","year":"2009","journal-title":"J. Infect. Dis."},{"key":"B18","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1056\/NEJMoa0808859","article-title":"Artemisinin resistance in Plasmodium falciparum malaria.","volume":"361","author":"Dondorp","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/s1097-2765(05)00077-8","article-title":"Mutations in the P. falciparum digestive vacuole transmembrane protein PfCRT and evidence for their role in chloroquine resistance.","volume":"6","author":"Fidock","year":"2000","journal-title":"Mol. Cell"},{"key":"B20","doi-asserted-by":"publisher","first-page":"857","DOI":"10.4269\/ajtmh.13-0129","article-title":"Trends in antimalarial drug use in Africa.","volume":"89","author":"Flegg","year":"2013","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1038\/345255a0","article-title":"Several alleles of the multidrug-resistance gene are closely linked to chloroquine resistance in Plasmodium falciparum.","volume":"345","author":"Foote","year":"1990","journal-title":"Nature"},{"key":"B22","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/1475-2875-10-116","article-title":"Patterns of chloroquine use and resistance in Sub-Saharan Africa: A systematic review of household survey and molecular data.","volume":"10","author":"Frosch","year":"2011","journal-title":"Malar. J."},{"key":"B23","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/1475-2875-9-174","article-title":"Plasmodium falciparum isolates from Angola show the StctVMNT haplotype in the pfcrt gene.","volume":"9","author":"Gama","year":"2010","journal-title":"Malar. J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"e01183","DOI":"10.1128\/AAC.01183-16","article-title":"Association between polymorphisms in the Pfmdr6 gene and ex vivo susceptibility to quinine in Plasmodium falciparum parasites from Dakar, Senegal.","volume":"61","author":"Gendrot","year":"2017","journal-title":"Antimicrob. Agents Chemother."},{"key":"B25","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1038\/nrmicro.2017.161","article-title":"Drug resistance in Plasmodium.","volume":"16","author":"Haldar","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1186\/s12936-019-2947-z","article-title":"Rare mutations in Pfmdr1 gene of Plasmodium falciparum detected in clinical isolates from patients treated with anti-malarial drug in Nigeria.","volume":"18","author":"Idowu","year":"2019","journal-title":"Malar. J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1128\/AAC.03554-14","article-title":"Temporal and seasonal changes of genetic polymorphisms associated with altered drug susceptibility to chloroquine, lumefantrine, and quinine in Guinea-Bissau between 2003 and 2012.","volume":"59","author":"Jovel","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"B28","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1038\/s41598-020-80017-6","article-title":"Polymorphisms in Plasmodium falciparum dihydropteroate synthetase and dihydrofolate reductase genes in Nigerian children with uncomplicated malaria using high-resolution melting technique.","volume":"11","author":"Kayode","year":"2021","journal-title":"Sci. Rep."},{"key":"B29","doi-asserted-by":"publisher","first-page":"2100","DOI":"10.1128\/AAC.44.8.2100-2108.2000","article-title":"Mutations in Plasmodium falciparum cytochrome b that are associated with atovaquone resistance are located at a putative drug-binding site.","volume":"44","author":"Korsinczky","year":"2000","journal-title":"Antimicrob. Agents Chemother."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1086\/375419","article-title":"Reemergence of chloroquine-sensitive Plasmodium falciparum malaria after cessation of chloroquine use in Malawi.","volume":"187","author":"Kublin","year":"2003","journal-title":"J. Infect. Dis."},{"key":"B31","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1086\/338566","article-title":"Molecular markers for failure of sulfadoxine-pyrimethamine and chlorproguanil-dapsone treatment of Plasmodium falciparum malaria.","volume":"185","author":"Kublin","year":"2002","journal-title":"J. Infect. Dis."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1093\/molbev\/msu140","article-title":"Origin of robustness in generating drug-resistant malaria parasites.","volume":"31","author":"Kumpornsin","year":"2014","journal-title":"Mol. Biol. Evol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"103680","DOI":"10.1016\/j.ebiom.2021.103680","article-title":"Plasmodium falciparum rosetting protects schizonts against artemisinin.","volume":"73","author":"Lee","year":"2021","journal-title":"EBioMedicine"},{"key":"B34","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1186\/s13071-017-2298-y","article-title":"Return of chloroquine sensitivity to Africa? Surveillance of African Plasmodium falciparum chloroquine resistance through malaria imported to China.","volume":"10","author":"Lu","year":"2017","journal-title":"Parasit. Vectors"},{"key":"B35","doi-asserted-by":"publisher","first-page":"W636","DOI":"10.1093\/nar\/gkz268","article-title":"The EMBL-EBI search and sequence analysis tools APIs in 2019.","volume":"47","author":"Madeira","year":"2019","journal-title":"Nucleic Acids Res."},{"key":"B36","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/1475-2875-12-103","article-title":"Temporal trends of molecular markers associated with artemether-lumefantrine tolerance\/resistance in Bagamoyo district, Tanzania.","volume":"12","author":"Malmberg","year":"","journal-title":"Malar. J."},{"key":"B37","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1093\/infdis\/jis747","article-title":"Plasmodium falciparum drug resistance phenotype as assessed by patient antimalarial drug levels and its association with pfmdr1 polymorphisms.","volume":"207","author":"Malmberg","year":"","journal-title":"J. Infect. Dis."},{"key":"B38","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1186\/s12936-016-1490-4","article-title":"Selection of N86F184D1246 haplotype of Pfmrd1 gene by artemether-lumefantrine drug pressure on Plasmodium falciparum populations in Senegal.","volume":"15","author":"Mbaye","year":"2016","journal-title":"Malar. J."},{"key":"B39","doi-asserted-by":"publisher","first-page":"2212","DOI":"10.1128\/AAC.00089-08","article-title":"Discordant patterns of genetic variation at two chloroquine resistance loci in worldwide populations of the malaria parasite Plasmodium falciparum.","volume":"52","author":"Mehlotra","year":"2008","journal-title":"Antimicrob. Agents Chemother."},{"key":"B40","doi-asserted-by":"publisher","first-page":"2453","DOI":"10.1056\/NEJMoa1513137","article-title":"A worldwide map of Plasmodium falciparum K13-propeller polymorphisms.","volume":"374","author":"Menard","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"2398","DOI":"10.1038\/s41598-017-02724-x","article-title":"High throughput resistance profiling of Plasmodium falciparum infections based on custom dual indexing and Illumina next generation sequencing-technology.","volume":"7","author":"Nag","year":"2017","journal-title":"Sci. Rep."},{"key":"B42","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1186\/s12936-019-2894-8","article-title":"Proof of concept: Used malaria rapid diagnostic tests applied for parallel sequencing for surveillance of molecular markers of anti-malarial resistance in Bissau, Guinea-Bissau during 2014-2017.","volume":"18","author":"Nag","year":"2019","journal-title":"Malar. J."},{"key":"B43","doi-asserted-by":"publisher","first-page":"e1000243","DOI":"10.1371\/journal.pgen.1000243","article-title":"Adaptive copy number evolution in malaria parasites.","volume":"4","author":"Nair","year":"2008","journal-title":"PLoS Genet."},{"key":"B44","doi-asserted-by":"publisher","first-page":"2619","DOI":"10.1056\/NEJMc0805011","article-title":"Evidence of artemisinin-resistant malaria in western Cambodia.","volume":"359","author":"Noedl","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"7389","DOI":"10.1038\/s41598-017-06708-9","article-title":"Mapping sulphadoxine-pyrimethamine-resistant Plasmodium falciparum malaria in infected humans and in parasite populations in Africa.","volume":"7","author":"Okell","year":"2017","journal-title":"Sci. Rep."},{"key":"B46","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/s0035-9203(01)90250-0","article-title":"Can pretreatment screening for dhps and dhfr point mutations in Plasmodium falciparum infections be used to predict sulfadoxine-pyrimethamine treatment failure?","volume":"95","author":"Omar","year":"2001","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"B47","doi-asserted-by":"publisher","first-page":"e0132021","DOI":"10.1128\/AAC.01320-21","article-title":"Mutation in Plasmodium falciparum BTB\/POZ domain of K13 protein confers artemisinin resistance.","volume":"66","author":"Paloque","year":"2021","journal-title":"Antimicrob. Agents Chemother."},{"key":"B48","doi-asserted-by":"publisher","first-page":"4052","DOI":"10.1038\/ncomms5052","article-title":"A barcode of organellar genome polymorphisms identifies the geographic origin of Plasmodium falciparum strains.","volume":"5","author":"Preston","year":"2014","journal-title":"Nat. Commun."},{"key":"B49","doi-asserted-by":"crossref","first-page":"441","DOI":"10.2217\/fmb.09.15","article-title":"Molecular and physiologic basis of quinoline drug resistance in Plasmodium falciparum malaria.","volume":"4","author":"Roepe","year":"2009","journal-title":"Future Microbiol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"3314","DOI":"10.1038\/s41467-018-05652-0","article-title":"Emerging southeast Asian PfCRT mutations confer Plasmodium falciparum resistance to the first-line antimalarial piperaquine.","volume":"9","author":"Ross","year":"2018","journal-title":"Nat. Commun."},{"key":"B51","doi-asserted-by":"publisher","first-page":"18883","DOI":"10.1073\/pnas.0911317106","article-title":"Geographic patterns of Plasmodium falciparum drug resistance distinguished by differential responses to amodiaquine and chloroquine.","volume":"106","author":"Sa","year":"2009","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"B52","doi-asserted-by":"publisher","first-page":"e1010278","DOI":"10.1371\/journal.ppat.1010278","article-title":"Evidence for the early emergence of piperaquine-resistant Plasmodium falciparum malaria and modeling strategies to mitigate resistance.","volume":"18","author":"Small-Saunders","year":"2022","journal-title":"PLoS Pathog."},{"key":"B53","doi-asserted-by":"publisher","first-page":"536","DOI":"10.4269\/ajtmh.12-0525","article-title":"Rapid selection of Plasmodium falciparum chloroquine resistance transporter gene and multidrug resistance gene-1 haplotypes associated with past chloroquine and present artemether-lumefantrine use in Inhambane district, southern Mozambique.","volume":"88","author":"Thomsen","year":"2013","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"B54","doi-asserted-by":"publisher","first-page":"13944","DOI":"10.1073\/pnas.94.25.13944","article-title":"Mutations in dihydropteroate synthase are responsible for sulfone and sulfonamide resistance in Plasmodium falciparum.","volume":"94","author":"Triglia","year":"1997","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"B55","doi-asserted-by":"publisher","first-page":"3807","DOI":"10.1093\/emboj\/17.14.3807","article-title":"Allelic exchange at the endogenous genomic locus in Plasmodium falciparum proves the role of dihydropteroate synthase in sulfadoxine-resistant malaria.","volume":"17","author":"Triglia","year":"1998","journal-title":"EMBO J."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1038\/s41591-020-1005-2","article-title":"Emergence and clonal expansion of in vitro artemisinin-resistant Plasmodium falciparum kelch13 R561H mutant parasites in Rwanda.","volume":"26","author":"Uwimana","year":"2020","journal-title":"Nat. Med."},{"key":"B57","doi-asserted-by":"publisher","first-page":"11553","DOI":"10.1038\/ncomms11553","article-title":"Globally prevalent PfMDR1 mutations modulate Plasmodium falciparum susceptibility to artemisinin-based combination therapies.","volume":"7","author":"Veiga","year":"2016","journal-title":"Nat. Commun."},{"key":"B58","year":"2010","journal-title":"Global report on antimalarial drug efficacy and drug resistance: 2000-2010."},{"key":"B59","year":"","journal-title":"WHO recommends groundbreaking malaria vaccine for children at risk."},{"key":"B60","year":"","journal-title":"World malaria report 2021."},{"key":"B61","year":"","journal-title":"WHO malaria policy advisory group (MPAG) meeting, October 2021, meeting report."},{"key":"B100","year":"2021"},{"key":"B62","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.4269\/ajtmh.17-0864","article-title":"Surveillance of antimalarial resistance molecular markers in imported Plasmodium falciparum malaria cases in Anhui, China, 2012-2016.","volume":"98","author":"Zhang","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"B63","first-page":"399","article-title":"[Analysis of Pfcrt gene polymorphism in imported falciparum malaria cases in Henan province in 2015].","volume":"34","author":"Zhou","year":"2016","journal-title":"Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi"}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2022.1059695\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T10:03:59Z","timestamp":1669975439000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2022.1059695\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,2]]},"references-count":64,"alternative-id":["10.3389\/fmicb.2022.1059695"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2022.1059695","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,2]]},"article-number":"1059695"}}