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Oxford University Press, The Journal of Infectious Diseases, 12(210), p. 2001-2008, 2014

DOI: 10.1093/infdis/jiu358

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Directional Selection at the pfmdr1, pfcrt, pfubp1, and pfap2mu Loci of Plasmodium falciparum in Kenyan Children Treated With ACT

Journal article published in 2014 by Gisela Henriques, Rachel L. Hallett, Khalid B. Beshir, Nahla B. Gadalla ORCID, Rachel E. Johnson, Rebekah Burrow ORCID, Donelly A. van Schalkwyk, D. A. van Schalkwyk, Patrick Sawa, Sabah A. Omar, Taane G. Clark, Teun Bousema, Colin J. Sutherland
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This paper is available in a repository.

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Abstract

BACKGROUND: The efficacy of artemisinin-based combination therapy (ACT) for Plasmodium falciparum malaria may be threatened by parasites with reduced responsiveness to artemisinins. Among 298 ACT-treated children from Mbita, Kenya, submicroscopic persistence of P. falciparum on day 3 posttreatment was associated with subsequent microscopically detected parasitemia at days 28 or 42. METHODS: DNA sequences of resistance-associated parasite loci pfcrt, pfmdr1, pfubp1, and pfap2mu were determined in the Mbita cohort before treatment, on days 2 and 3 after initiation of treatment, and on the day of treatment failure. RESULTS: Parasites surviving ACT on day 2 or day 3 posttreatment were significantly more likely than the baseline population to carry the wild-type haplotypes of pfcrt (CVMNK at codons 72-76; P