{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:33:58Z","timestamp":1760146438705,"version":"build-2065373602"},"reference-count":55,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Expertise France","award":["22SANIC803"],"award-info":[{"award-number":["22SANIC803"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Djibouti is confronted with malaria resurgence, with malaria having been occurring in epidemic proportions since a decade ago. The current epidemiology of drug-resistant Plasmodium falciparum is not well known. Molecular markers were analyzed by targeted sequencing in 79 P. falciparum clinical isolates collected in Djibouti city in 2023 using the Miseq Illumina platform newly installed in the country. The objective of the study was to analyze the key codons in these molecular markers associated with antimalarial drug resistance. The prevalence of the mutant Pfcrt CVIET haplotype (92%) associated with chloroquine resistance and mutant Pfdhps-Pfdhfr haplotypes (7.4% SGEA and 53.5% IRN, respectively) associated with sulfadoxine-pyrimethamine resistance was high. By contrast, Pfmdr1 haplotypes associated with amodiaquine (YYY) or lumefantrine (NFD) resistance were not observed in any of the isolates. Although the \u201cAsian-type\u201d PfK13 mutations associated with artemisinin resistance were not observed, the \u201cAfrican-type\u201d PfK13 substitution, R622I, was found in a single isolate (1.4%) for the first time in Djibouti. Our genotyping data suggest that most Djiboutian P. falciparum isolates are resistant to chloroquine and sulfadoxine-pyrimethamine but are sensitive to amodiaquine, lumefantrine, and artemisinin. Nonetheless, the presence of an isolate with the R622I PfK13 substitution is a warning signal that calls for a regular surveillance of molecular markers of antimalarial drug resistance.<\/jats:p>","DOI":"10.3390\/biology13110905","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T09:16:51Z","timestamp":1730884611000},"page":"905","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Setting Up an NGS Sequencing Platform and Monitoring Molecular Markers of Anti-Malarial Drug Resistance in Djibouti"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1415-4882","authenticated-orcid":false,"given":"Nasserdine","family":"Papa Mze","sequence":"first","affiliation":[{"name":"Service de Biologie, Unit\u00e9 de Microbiologie, H\u00f4pital Mignot, Centre Hospitalier de Versailles, 177 rue de Versailles, 78150 Le Chesnay, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Houssein Yonis","family":"Arreh","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Biologie Mol\u00e9culaire, H\u00f4pital G\u00e9n\u00e9ral de Peltier, Centre Hospitalier Universitaire de Djibouti, Avenue Marechal, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahma Abdi","family":"Moussa","sequence":"additional","affiliation":[{"name":"Caisse Nationale de S\u00e9curit\u00e9 Sociale (CNSS), Minist\u00e8re de la Sant\u00e9, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahdi Bachir","family":"Elmi","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Biologie Mol\u00e9culaire, H\u00f4pital G\u00e9n\u00e9ral de Peltier, Centre Hospitalier Universitaire de Djibouti, Avenue Marechal, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Ahmed","family":"Waiss","sequence":"additional","affiliation":[{"name":"Laboratoire du Service de Sant\u00e9 de la Gendarmerie Nationale, Avenue de Brazzaville, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Migane","family":"Abdi","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Biologie Mol\u00e9culaire, H\u00f4pital G\u00e9n\u00e9ral de Peltier, Centre Hospitalier Universitaire de Djibouti, Avenue Marechal, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan Ibrahim","family":"Robleh","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Biologie Mol\u00e9culaire, H\u00f4pital G\u00e9n\u00e9ral de Peltier, Centre Hospitalier Universitaire de Djibouti, Avenue Marechal, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samatar Kayad","family":"Guelleh","sequence":"additional","affiliation":[{"name":"Programme National de Lutte contre le Paludisme, Minist\u00e8re de la Sant\u00e9, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdoul-ilah Ahmed","family":"Abdi","sequence":"additional","affiliation":[{"name":"Pr\u00e9sidence de la R\u00e9publique de Djibouti, Commune de Ras Dika, Djibouti ville 98230, Djibouti"},{"name":"Service de Sant\u00e9 des Arm\u00e9es, Forces Arm\u00e9es Djiboutiennes, Commune de Boulaos, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herv\u00e9","family":"Bogreau","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Parasitologie et Entomologie, D\u00e9partement Microbiologie et Maladies Infectieuses, Institut de Recherche Biom\u00e9dicale des Arm\u00e9es, 13005 Marseille, France"},{"name":"Centre National de R\u00e9f\u00e9rence du Paludisme, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8812-8185","authenticated-orcid":false,"given":"Leonardo K.","family":"Basco","sequence":"additional","affiliation":[{"name":"Aix Marseille Universit\u00e9, Institut de Recherche pour le D\u00e9veloppement (IRD), Assistance Publique-H\u00f4pitaux de Marseille (AP-HM), Service de Sant\u00e9 des Arm\u00e9es (SSA), 13005 Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4861-1831","authenticated-orcid":false,"given":"Bouh Abdi","family":"Khaireh","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Biologie Mol\u00e9culaire, H\u00f4pital G\u00e9n\u00e9ral de Peltier, Centre Hospitalier Universitaire de Djibouti, Avenue Marechal, Djibouti ville 98230, Djibouti"},{"name":"Ministry of Health, Global Fund to Fight AIDS-TB-Malaria Project, Djibouti ville 98230, Djibouti"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023). World Malaria Report 2023, World Health Organization. Available online: https:\/\/www.who.int\/teams\/global-malaria-programme\/reports\/world-malaria-report-2023."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/B978-0-12-394303-3.00010-4","article-title":"The changing limits and incidence of malaria in Africa: 1939\u20132009","volume":"78","author":"Snow","year":"2012","journal-title":"Adv. Parasitol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"317","DOI":"10.3201\/eid1102.040108","article-title":"Malaria epidemic and drug resistance, Djibouti","volume":"11","author":"Rogier","year":"2005","journal-title":"Emerg. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/1475-2875-12-201","article-title":"Population genetics analysis during the elimination process of Plasmodium falciparum in Djibouti","volume":"12","author":"Khaireh","year":"2013","journal-title":"Malar. J."},{"key":"ref_5","unstructured":"World Health Organization (2016). World Malaria Report 2016, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241511711."},{"key":"ref_6","unstructured":"Schapira, A., Ahoranayezu, J.B., Al-Eriyani, S., Bosman, A., Boulhan, A., Abdi Khaireh, B., Mudambo, K., and Zamani, G. (2019). Revue du Programme National de Lutte Contre le Paludisme Couvrant la P\u00e9riode 2012\u20132018, Revised on 23 February 2019, Ministry of Health. Available online: https:\/\/erc.undp.org\/evaluation\/managementresponses\/keyaction\/documents\/download\/2288."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1080\/22221751.2020.1815590","article-title":"Misdiagnosis of imported falciparum malaria from African areas due to an increased prevalence of pfhrp2\/pfhrp3 gene deletion: The Djibouti case","volume":"9","author":"Iriart","year":"2020","journal-title":"Emerg. Microbes Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.3201\/eid2810.220695","article-title":"Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions and relatedness to other global isolates, Djibouti, 2019\u20132020","volume":"28","author":"Rogier","year":"2022","journal-title":"Emerg. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s12936-023-04546-x","article-title":"Molecular investigation of malaria-infected patients in Djibouti city (2018\u20132021)","volume":"22","author":"Moussa","year":"2023","journal-title":"Malar. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1186\/s12936-016-1535-8","article-title":"Failure of dihydroartemisinin plus piperaquine treatment of falciparum malaria by under-dosing in an overweight patient","volume":"15","author":"Roseau","year":"2016","journal-title":"Malar. J."},{"key":"ref_11","doi-asserted-by":"crossref","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":"ref_12","doi-asserted-by":"crossref","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":"ref_13","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1016\/S0140-6736(12)60484-X","article-title":"Emergence of artemisinin-resistant malaria on the western border of Thailand: A longitudinal study","volume":"379","author":"Phyo","year":"2012","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","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":"ref_15","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1056\/NEJMoa1513137","article-title":"A Worldwide map of Plasmodium falciparum K13-propeller polymorphisms","volume":"374","author":"Khim","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1126\/science.aav5427","article-title":"Major subpopulations of Plasmodium falciparum in sub-Saharan Africa","volume":"365","author":"Kamau","year":"2019","journal-title":"Science"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ijpddr.2021.06.001","article-title":"A review of the frequencies of Plasmodium falciparum Kelch 13 artemisinin resistance mutations in Africa","volume":"16","author":"Ndwiga","year":"2021","journal-title":"Int. J. Parasitol. Drugs Drug Resist."},{"key":"ref_18","first-page":"1030","article-title":"Artemisinin resistance increasing","volume":"330","author":"Harris","year":"2023","journal-title":"JAMA"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3225","DOI":"10.1128\/AAC.00777-06","article-title":"In vitro activity of tafenoquine against the asexual blood stages of Plasmodium falciparum isolates from Gabon, Senegal, and Djibouti","volume":"50","author":"Pradines","year":"2006","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","unstructured":"World Health Organization (2023). WHO Guidelines for Malaria, 16 October 2023, World Health Organization. Available online: www.who.int\/teams\/global-malaria-programme\/guidelines-for-malaria."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Abdi Moussa, R., Papa Mze, N., Yonis Arreh, H., Abdillahi Hamoud, A., Mohamed Alaleh, K., Mohamed Aden, F., Yonis Omar, A.R., Osman Abdi, W., Kayad Guelleh, S., and Ahmed Abdi, A.I. (2024). Assessment of the performance of lactate dehydrogenase-based rapid diagnostic test for malaria in Djibouti in 2022\u20132023. Diagnostics, 14.","DOI":"10.3390\/diagnostics14030262"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1038\/s41564-023-01461-4","article-title":"Plasmodium falciparum resistant to artemisinin and diagnostics have emerged in Ethiopia","volume":"8","author":"Fola","year":"2023","journal-title":"Nat. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s12936-023-04812-y","article-title":"Molecular surveillance of Kelch 13 polymorphisms in Plasmodium falciparum isolates from Kenya and Ethiopia","volume":"23","author":"Jeang","year":"2024","journal-title":"Malar. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4572","DOI":"10.1093\/bioinformatics\/btab705","article-title":"New strategies to improve minimap2 alignment accuracy","volume":"37","author":"Li","year":"2021","journal-title":"Bioinformatics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"giab008","DOI":"10.1093\/gigascience\/giab008","article-title":"Twelve years of SAMtools and BCFtools","volume":"10","author":"Danecek","year":"2021","journal-title":"Gigascience"},{"key":"ref_26","unstructured":"Geneious (2024). Geneious Primer User Manual, Biomatters, Inc.. Available online: https:\/\/manual.geneious.com\/en\/latest\/."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/nbt.1754","article-title":"Integrative genomics viewer","volume":"29","author":"Robinson","year":"2011","journal-title":"Nat. Biotechnol."},{"key":"ref_28","unstructured":"Programme de National de Lutte contre le Paludisme \u00e0 Djibouti (2023). Rapport Annuel des Activit\u00e9s 2023, Ministry of Health."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0140-6736(01)06227-4","article-title":"Trimethoprim-sulfamethoxazole prophylaxis in sub-Saharan Africa","volume":"358","author":"Anglaret","year":"2001","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/S0140-6736(02)07300-2","article-title":"Plasmodium falciparum cross resistance","volume":"359","author":"Whitty","year":"2002","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s12936-022-04115-8","article-title":"Malaria chemoprevention and drug resistance: A review of the literature and policy implications","volume":"21","author":"Plowe","year":"2022","journal-title":"Malar. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1111\/tmi.12458","article-title":"Treatment of uncomplicated malaria with artesunate plus sulfadoxine-pyrimethamine is failing in Somalia: Evidence from therapeutic efficacy studies and Pfdhfr and Pfdhps mutant alleles","volume":"20","author":"Warsame","year":"2015","journal-title":"Trop. Med. Int. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/tmi.12847","article-title":"Efficacy of artesunate + sulphadoxine\/pyrimethamine and artemether + lumefantrine and dhfr and dhps mutations in Somalia: Evidence for updating the malaria treatment policy","volume":"22","author":"Warsame","year":"2017","journal-title":"Trop. Med. Int. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.4269\/ajtmh.2005.73.1131","article-title":"Molecular surveillance of mutations in dihydrofolate reductase and dihydropteroate synthase genes of Plasmodium falciparum in Ethiopia","volume":"73","author":"Hailu","year":"2005","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1475-2875-5-54","article-title":"High prevalence of drug-resistance mutations in Plasmodium falciparum and Plasmodium vivax in southern Ethiopia","volume":"5","author":"Schunk","year":"2006","journal-title":"Malar. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1186\/1475-2875-10-214","article-title":"Detection of high levels of mutations involved in anti-malarial drug resistance in Plasmodium falciparum and Plasmodium vivax at a rural hospital in southern Ethiopia","volume":"10","author":"Mula","year":"2011","journal-title":"Malar. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.actatropica.2013.09.010","article-title":"Prevalence of sulfadoxine-pyrimethamine resistance-associated mutations in dhfr and dhps genes of Plasmodium falciparum three years after SP withdrawal in Bahir Dar, Northwest Ethiopia","volume":"128","author":"Hailemeskel","year":"2013","journal-title":"Acta Trop."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Tessema, S.K., Kassa, M., Kebede, A., Mohammed, H., Leta, G.T., Woyessa, A., Guma, G.T., and Petros, B. (2015). Declining trend of Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutant alleles after the withdrawal of sulfadoxine-pyrimethamine in North Western Ethiopia. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0126943"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s12936-022-04304-5","article-title":"High prevalence of Pfcrt 76T and Pfmdr1 N86 genotypes in malaria infected patients attending health facilities in East Shewa zone, Oromia Regional State, Ethiopia","volume":"21","author":"Hassen","year":"2022","journal-title":"Malar. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/1475-2875-12-35","article-title":"Longitudinal study assessing the return of chloroquine susceptibility of Plasmodium falciparum in isolates from travellers returning from West and Central Africa, 2000\u20132011","volume":"12","author":"Gharbi","year":"2013","journal-title":"Malar. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1186\/s12936-021-03985-8","article-title":"The emergence of chloroquine-sensitive Plasmodium falciparum is influenced by selected communities in some parts of the Central Region of Ghana","volume":"20","author":"Asare","year":"2021","journal-title":"Malar. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1186\/s12936-022-04284-6","article-title":"Temporal trends in molecular markers of drug resistance in Plasmodium falciparum in human blood and profiles of corresponding resistant markers in mosquito oocysts in Asembo, western Kenya","volume":"21","author":"Zhou","year":"2022","journal-title":"Malar. J."},{"key":"ref_43","doi-asserted-by":"crossref","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":"ref_44","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1093\/infdis\/jiu216","article-title":"Return of widespread chloroquine-sensitive Plasmodium falciparum to Malawi","volume":"210","author":"Frosch","year":"2014","journal-title":"J. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1186\/1475-2875-13-244","article-title":"Return of chloroquine-sensitive Plasmodium falciparum parasites and emergence of chloroquine-resistant Plasmodium vivax in Ethiopia","volume":"13","author":"Mekonnen","year":"2014","journal-title":"Malar. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1186\/s12936-016-1637-3","article-title":"The return of chloroquine-susceptible Plasmodium falciparum malaria in Zambia","volume":"15","author":"Mwanza","year":"2016","journal-title":"Malar. J."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Sondo, P., Derra, K., Diallo Nakanabo, S., Tarnagda, Z., Kazienga, A., Zampa, O., Val\u00e9a, I., Sorgho, H., Owusu-Dabo, E., and Ou\u00e9draogo, J.B. (2016). Artesunate-amodiaquine and artemether-lumefantrine therapies and selection of Pfcrt and Pfmdr1 alleles in Nanoro, Burkina Faso. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151565"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e000999","DOI":"10.1136\/bmjgh-2018-000999","article-title":"Emerging implications of policies on malaria treatment: Genetic changes in the Pfmdr-1 gene affecting susceptibility to artemether-lumefantrine and artesunate-amodiaquine in Africa","volume":"3","author":"Okell","year":"2018","journal-title":"BMJ Glob. Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"7540","DOI":"10.1128\/AAC.01894-15","article-title":"In vitro and molecular surveillance for antimalarial drug resistance in Plasmodium falciparum parasites in Western Kenya reveals sustained artemisinin sensitivity and increased chloroquine sensitivity","volume":"59","author":"Lucchi","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1186\/s12936-021-03745-8","article-title":"Efficacy and safety of artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia: A systematic review and meta-analysis","volume":"20","author":"Abamecha","year":"2021","journal-title":"Malar. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e0000222","DOI":"10.1128\/aac.00002-22","article-title":"Persistence of residual submicroscopic P. falciparum parasitemia following treatment of artemether-lumefantrine in Ethio-Sudan Border, Western Ethiopia","volume":"66","author":"Tadele","year":"2022","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12936-020-3140-0","article-title":"Molecular surveillance of Pfcrt and k13 propeller polymorphisms of imported Plasmodium falciparum cases to Zhejiang Province, China between 2016 and 2018","volume":"19","author":"Wang","year":"2020","journal-title":"Malar. J."},{"key":"ref_53","unstructured":"World Health Organization (2020). Report on Antimalarial Drug Efficacy, Resistance and Response: 10 Years of Surveillance (2010\u20132019), World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240012813."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"taad114","DOI":"10.1093\/jtm\/taad114","article-title":"Emergence of artemisinin-based combination treatment failure in patients returning from sub-Saharan Africa with P. falciparum malaria","volume":"30","author":"Grossman","year":"2023","journal-title":"J. Travel Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ijid.2023.03.050","article-title":"Evolution of Plasmodium falciparum antimalarial drug resistance markers post-adoption of artemisinin-based combination therapies in Yaounde, Cameroon","volume":"132","author":"Niba","year":"2023","journal-title":"Int. J. Infect. Dis."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/13\/11\/905\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:27:23Z","timestamp":1760113643000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/13\/11\/905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,6]]},"references-count":55,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["biology13110905"],"URL":"https:\/\/doi.org\/10.3390\/biology13110905","relation":{},"ISSN":["2079-7737"],"issn-type":[{"type":"electronic","value":"2079-7737"}],"subject":[],"published":{"date-parts":[[2024,11,6]]}}}