{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:07:26Z","timestamp":1776258446012,"version":"3.50.1"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,5]]},"abstract":"In most of India, sulfadoxine\u2013pyrimethamine (SP) plus<\/jats:italic> artesunate serves as first-line treatment for uncomplicated falciparum malaria. In 112 clinical Plasmodium falciparum<\/jats:italic> isolates from Mangaluru, southwestern India, we sequenced molecular markers associated with resistance to SP, lumefantrine, and artemisinin (pfdhfr<\/jats:italic>, pfdhps<\/jats:italic>, pfmdr1<\/jats:italic>, and K13<\/jats:italic>). The pfdhfr<\/jats:italic> double mutation 59R-108N combined with the dhps<\/jats:italic> 437G mutation occurred in 39.3% and the pfdhfr<\/jats:italic> double mutation plus<\/jats:italic> the pfdhps<\/jats:italic> double mutation 437G-540E in additional 24.1%. As for pfmdr1<\/jats:italic>, the allele combination N86-184F-D1246 dominated (98.2%). K13<\/jats:italic> variants were absent. No evidence for artemisinin resistance was seen. However, the antifolate resistance alleles compromise the current first-line antimalarial sulfadoxine\u2013pyrimethamine plus<\/jats:italic> artesunate, which may facilitate the emergence of artemisinin resistance. Artemether\u2013lumefantrine, introduced in northeastern parts of the country, in the study area faces the predominant pfmdr1<\/jats:italic> NFD genotype, known to impair lumefantrine efficacy. Further monitoring of resistance alleles and treatment trials on alternative artemisinin-based combination therapies are required.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0549","type":"journal-article","created":{"date-parts":[[2018,11,6]],"date-time":"2018-11-06T07:00:21Z","timestamp":1541487621000},"page":"1508-1510","source":"Crossref","is-referenced-by-count":8,"title":["Molecular Evidence for Plasmodium falciparum Resistance to Sulfadoxine\u2013Pyrimethamine but Absence of K13 Mutations in Mangaluru, Southwestern India"],"prefix":"10.4269","volume":"99","author":[{"given":"Jakob","family":"Wedam","sequence":"first","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costanza","family":"Tacoli","sequence":"additional","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhanjan P.","family":"Gai","sequence":"additional","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konrad","family":"Siegert","sequence":"additional","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suyamindra S.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Karnataka Institute for DNA Research, Dharwad-Hubli, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashmi","family":"Rasalkar","sequence":"additional","affiliation":[{"name":"Karnataka Institute for DNA Research, Dharwad-Hubli, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archith","family":"Boloor","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Animesh","family":"Jain","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chakrapani","family":"Mahabala","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shantaram","family":"Baliga","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damodara","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeshwari","family":"Devi","sequence":"additional","affiliation":[{"name":"Wenlock Hospital, Mangaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pramod","family":"Gai","sequence":"additional","affiliation":[{"name":"Karnataka Institute for DNA Research, Dharwad-Hubli, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank P.","family":"Mockenhaupt","sequence":"additional","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Nat Rev Microbiol","first-page":"156","article-title":"Drug resistance in Plasmodium","volume":"16","author":"Haldar","year":"2018"},{"key":"b2","author":"Directorate of National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India","year":"2013"},{"key":"b3","series-title":"Lancet Infect Dis","first-page":"57","article-title":"Antimalarial drug resistance of Plasmodium falciparum in India: changes over time and space","volume":"11","author":"Shah","year":"2011"},{"key":"b4","series-title":"Sci Rep","first-page":"16690","article-title":"Prevalence of mutations linked to antimalarial resistance in Plasmodium falciparum from Chhattisgarh, Central India: a malaria elimination point of view","volume":"7","author":"Patel","year":"2017"},{"key":"b5","series-title":"Malar J","first-page":"182","article-title":"Characterization of drug resistance associated genetic polymorphisms among Plasmodium falciparum field isolates in Ujjain, Madhya Pradesh, India","volume":"13","author":"Pathak","year":"2014"},{"key":"b6","series-title":"PLoS One","first-page":"e105562","article-title":"Molecular evidence of increased resistance to anti-folate drugs in Plasmodium falciparum in north-east India: a signal for potential failure of artemisinin plus sulphadoxine-pyrimethamine combination therapy","volume":"9","author":"Mohapatra","year":"2014"},{"key":"b7","series-title":"Malar J","first-page":"284","article-title":"Declining efficacy of artesunate plus sulphadoxine-pyrimethamine in northeastern India","volume":"13","author":"Mishra","year":"2014"},{"key":"b8","series-title":"J Vector Borne Dis","first-page":"116","article-title":"Molecular determination of antifolate resistance associated point mutations in Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) genes among the field samples in Arunachal Pradesh","volume":"52","author":"Sharma","year":"2015"},{"key":"b9","series-title":"Pharmacol Rev","first-page":"117","article-title":"Mechanisms of resistance of malaria parasites to antifolates","volume":"57","author":"Gregson","year":"2005"},{"key":"b10","series-title":"J Infect Dis","first-page":"130","article-title":"Ordered accumulation of mutations conferring resistance to sulfadoxine-pyrimethamine in the Plasmodium falciparum parasite","volume":"209","author":"Mita","year":"2014"},{"key":"b11","series-title":"Nat Med","first-page":"917","article-title":"Antimalarial drug resistance: linking Plasmodium falciparum parasite biology to the clinic","volume":"23","author":"Blasco","year":"2017"},{"key":"b12","series-title":"Malar J","first-page":"583","article-title":"Emerging polymorphisms in falciparum Kelch 13 gene in northeastern region of India","volume":"15","author":"Mishra","year":"2016"},{"key":"b13","series-title":"Malar J","first-page":"313","article-title":"Manifestation of malaria in Mangaluru, southern India","volume":"17","author":"Gai","year":"2018"},{"key":"b14","series-title":"Mol Biochem Parasitol","first-page":"283","article-title":"Identification of the four human malaria parasite species in field samples by the polymerase chain reaction and detection of a high prevalence of mixed infections","volume":"58","author":"Snounou","year":"1993"},{"key":"b15","series-title":"J Infect Dis","first-page":"380","article-title":"Molecular markers for failure of sulfadoxine-pyrimethamine and chlorproguanil-dapsone treatment of Plasmodium falciparum malaria","volume":"185","author":"Kublin","year":"2002"},{"key":"b16","series-title":"Trans R Soc Trop Med Hyg","first-page":"43","article-title":"Mutations in the pfmdr1, dhfr and dhps genes of Plasmodium falciparum are associated with in-vivo drug resistance in West Papua, Indonesia","volume":"95","author":"Nagesha","year":"2001"},{"key":"b17","series-title":"Nat Commun","first-page":"11553","article-title":"Globally prevalent PfMDR1 mutations modulate Plasmodium falciparum susceptibility to artemisinin-based combination therapies","volume":"7","author":"Veiga","year":"2016"},{"key":"b18","series-title":"Am J Trop Med Hyg","first-page":"833","article-title":"Polymorphisms in Plasmodium falciparum chloroquine resistance transporter and multidrug resistance 1 genes: parasite risk factors that affect treatment outcomes for P. falciparum malaria after artemether-lumefantrine and artesunate-amodiaquine","volume":"91","author":"Venkatesan","year":"2014"},{"key":"b19","series-title":"J Infect Dis","first-page":"842","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":"2013"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/6\/article-p1508.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/6\/article-p1508.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/6\/article-p1508.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T20:40:35Z","timestamp":1722458435000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/6\/article-p1508.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,5]]},"references-count":19,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0549","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,5]]}}}