{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:04:52Z","timestamp":1789139092253,"version":"build-2803163510"},"reference-count":118,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Dihydroartemisinin\u2013piperaquine (DP), the first-line treatment for uncomplicated malaria in Timika, Papua, Indonesia, has also been used for intermittent preventive treatment in pregnancy (IPTp-DP) since February 2022. Concerns about the potential emergence of drug resistance associated with this dual policy prompted the present study, which was conducted to assess DP efficacy in treating uncomplicated\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    (\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    ) and\n                    <jats:italic>Plasmodium vivax<\/jats:italic>\n                    (\n                    <jats:italic>P. vivax<\/jats:italic>\n                    ) malaria in the general population 15 months after IPTp-DP was introduced. Between May and December 2023, the current study recruited 75\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    and 75\n                    <jats:italic>P. vivax<\/jats:italic>\n                    malaria patients, who received supervised DP treatment for 3 days. Clinical and laboratory data were collected daily (on days 1, 2, 3, and 7) and then weekly for 6 weeks. Molecular analysis was performed to detect genetic markers of\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    resistance to DP and distinguish between recrudescence and reinfection. A total of 68\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    and 58\n                    <jats:italic>P. vivax<\/jats:italic>\n                    patients completed their day 42 follow-up. The cumulative risk of same-species recurrence by day 42 was 1.5% (95% CI: 0\u20137.9%) in\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    patients (polymerase chain reaction-adjusted) and 5.2% (95% CI: 1.1\u201314.1%) for\n                    <jats:italic>P. vivax<\/jats:italic>\n                    patients (unadjusted). No patients exhibited parasitemia on day 3. No\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    isolates carried\n                    <jats:italic>kelch 13<\/jats:italic>\n                    gene mutations or exhibited increased\n                    <jats:italic>plasmepsin<\/jats:italic>\n                    2\u20133 copy numbers on either day 0 (0\/75) or at recurrence (0\/2). At the current level of IPTp-DP coverage (824 doses administered), there was no evidence of high treatment failure rates or the selection of resistant parasites in patients with uncomplicated malaria treated with DP. Continuous monitoring of DP efficacy remains crucial for both treatment and chemoprevention.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0291","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T15:21:43Z","timestamp":1762874503000},"page":"115-122","source":"Crossref","is-referenced-by-count":1,"title":["Treatment Efficacy of Dihydroartemisinin\u2013Piperaquine for Uncomplicated Plasmodium falciparum and Plasmodium vivax Malaria in Timika, Papua, Indonesia"],"prefix":"10.4269","volume":"114","author":[{"given":"Noy Norman","family":"Kambuaya","sequence":"first","affiliation":[{"name":"Timika Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Syawal Satria","family":"Ramli","sequence":"additional","affiliation":[{"name":"Timika Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freis","family":"Candrawati","sequence":"additional","affiliation":[{"name":"Timika Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enny","family":"Kenangalem","sequence":"additional","affiliation":[{"name":"Timika Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pak","family":"Prayoga","sequence":"additional","affiliation":[{"name":"Timika Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agatha Mia","family":"Puspitasari","sequence":"additional","affiliation":[{"name":"Exeins Health Initiative, Jakarta, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintis","family":"Noviyanti","sequence":"additional","affiliation":[{"name":"Eijkman Research Center for Molecular Biology-BRIN, Jakarta, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leily","family":"Trianty","sequence":"additional","affiliation":[{"name":"Eijkman Research Center for Molecular Biology-BRIN, Jakarta, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratni","family":"Indrawanti","sequence":"additional","affiliation":[{"name":"Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada\/Dr. Sardjito Hospital, Yogyakarta, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minerva","family":"Simatupang","sequence":"additional","affiliation":[{"name":"Indonesian Ministry of Health, Jakarta, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reynold R.","family":"Ubra","sequence":"additional","affiliation":[{"name":"Mimika District Health Office, Timika, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdaus","family":"Hafidz","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;"},{"name":"Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne Rini","family":"Poespoprodjo","sequence":"additional","affiliation":[{"name":"Timika Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia;"},{"name":"Centre for Child Health-PRO, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia;"},{"name":"Mimika District Hospital, Timika, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"Mimika District Health Report.","year":"2023"},{"key":"b2","series-title":"Clin Infect Dis","first-page":"1374","article-title":"Adverse pregnancy outcomes in an area where multidrug-resistant plasmodium vivax and Plasmodium falciparum infections are endemic","volume":"46","author":"Poespoprodjo","year":"2008"},{"key":"b3","series-title":"Trans R Soc Trop Med Hyg","first-page":"351","article-title":"Therapeutic response of multidrug-resistant Plasmodium falciparum and P. vivax to chloroquine and sulfadoxine-pyrimethamine in southern Papua, Indonesia","volume":"101","author":"Ratcliff","year":"2007"},{"key":"b4","series-title":"Am J Trop Med Hyg","first-page":"677","article-title":"Therapeutic response to dihydroartemisinin-piperaquine for P. falciparum and P. vivax nine years after its introduction in Southern Papua, Indonesia","volume":"98","author":"Poespoprodjo","year":"2018"},{"key":"b5","series-title":"PLoS Med","first-page":"e3","article-title":"Intermittent presumptive treatment for malaria","volume":"2","author":"White","year":"2005"},{"key":"b6","series-title":"Lancet Infect Dis","first-page":"973","article-title":"Efficacy and safety of intermittent preventive treatment and intermittent screening and treatment versus single screening and treatment with dihydroartemisinin-piperaquine for the control of malaria in pregnancy in Indonesia: A cluster-randomised, open-label, superiority trial","volume":"19","author":"Ahmed","year":"2019"},{"key":"b7","series-title":"Lancet Prim Care","first-page":"100011","article-title":"Pilot implementation of intermittent preventive treatment with dihydroartemisinin-piperaquine to prevent adverse birth outcomes in Papua, Indonesia: A mixed-method evaluation","volume":"1","author":"Hafidz","year":"2025"},{"key":"b8","article-title":"Policy on Malaria Prevention in Pregnant Women through Preventive DHP Administration in Mimika District. Decree No. 443.41\/89\/2022.","year":"2022"},{"key":"b9","article-title":"WHO Guidelines for Malaria (November 2022).","year":"2022"},{"key":"b10","series-title":"Antimicrob Agents Chemother","first-page":"1589","article-title":"Pharmacokinetic determinants of the window of selection for antimalarial drug resistance","volume":"52","author":"Stepniewska","year":"2008"},{"key":"b11","series-title":"Antimicrob Agents Chemother","first-page":"e01393-18","article-title":"Modeling prevention of malaria and selection of drug resistance with different dosing schedules of dihydroartemisinin-piperaquine preventive therapy during pregnancy in Uganda","volume":"63","author":"Wallender","year":"2019"},{"key":"b12","series-title":"Malar J","first-page":"104","article-title":"Malaria chemoprevention and drug resistance: A review of the literature and policy implications","volume":"21","author":"Plowe","year":"2022"},{"key":"b13","article-title":"Mimika Regency in Figures 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Health Office Malaria Report, 2019.","year":"2019"},{"key":"b47","series-title":"J Clin Invest","first-page":"1084","article-title":"Antimalarial drug resistance","volume":"113","author":"White","year":"2004"},{"key":"b48","article-title":"WHO Guidelines for Malaria, 30 November 2024.","year":"2024"},{"key":"b49","series-title":"Am J Trop Med Hyg","first-page":"1088","article-title":"Efficacy and safety of pyronaridine-artesunate for the treatment of uncomplicated Plasmodium falciparum and Plasmodium vivax malaria in Myanmar","volume":"103","author":"Han","year":"2020"},{"key":"b50","series-title":"Cochrane Database Syst Rev","first-page":"CD006404","article-title":"Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria","volume":"1","author":"Pryce","year":"2019"},{"key":"b51","series-title":"Am J Trop Med Hyg","first-page":"1019","article-title":"Risk factors for gametocyte carriage in uncomplicated falciparum 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