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dc.contributor.authorMaiga, Hamma
dc.contributor.authorGrivoyannis, Anastasia
dc.contributor.authorSagara, Issaka
dc.contributor.authorTraore, Karim
dc.contributor.authorTraore, Oumar B.
dc.contributor.authorTolo, Youssouf
dc.contributor.authorTraore, Aliou
dc.contributor.authorBamadio, Amadou
dc.contributor.authorTraore, Zoumana I.
dc.contributor.authorSanogo, Kassim
dc.contributor.authorDoumbo, Ogobara K.
dc.contributor.authorPlowe, Christopher V.
dc.contributor.authorDjimde, Abdoulaye A.
dc.date.accessioned2021-06-11T13:24:15Z
dc.date.available2021-06-11T13:24:15Z
dc.date.issued2021-06-03
dc.identifier.urihttp://hdl.handle.net/10713/15992
dc.description.abstractBackground: Artemether-lumefantrine is a highly effective artemisinin-based combination therapy that was adopted in Mali as first-line treatment for uncomplicated Plasmodium falciparum malaria. This study was designed to measure the efficacy of artemether-lumefantrine and to assess the selection of the P. falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multi-drug resistance 1 (pfmdr1) genotypes that have been associated with drug resistance. Methods: A 28-day follow-up efficacy trial of artemether-lumefantrine was conducted in patients aged 6 months and older suffering from uncomplicated falciparum malaria in four different Malian areas during the 2009 malaria transmission season. The polymorphic genetic markers MSP2, MSP1, and Ca1 were used to distinguish between recrudescence and reinfection. Reinfection and recrudescence were then grouped as recurrent infections and analyzed together by PCR-restriction fragment length polymorphism (RFLP) to identify candidate markers for artemether-lumefantrine tolerance in the P. falciparum chloroquine resistance transporter (pfcrt) gene and the P. falciparum multi-drug resistance 1 (pfmdr1) gene. Results: Clinical outcomes in 326 patients (96.7%) were analyzed and the 28-day uncorrected adequate clinical and parasitological response (ACPR) rate was 73.9%. The total PCR-corrected 28-day ACPR was 97.2%. The pfcrt 76T and pfmdr1 86Y population prevalence decreased from 49.3% and 11.0% at baseline (n = 337) to 38.8% and 0% in patients with recurrent infection (n = 85); p = 0.001), respectively. Conclusion: Parasite populations exposed to artemether-lumefantrine in this study were selected toward chloroquine-sensitivity and showed a promising trend that may warrant future targeted reintroduction of chloroquine or/and amodiaquine. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.en_US
dc.description.sponsorshipFogarty International Centeren_US
dc.description.urihttps://doi.org/10.3390/ijms22116057en_US
dc.language.isoenen_US
dc.publisherMDPI AGen_US
dc.relation.ispartofInternational Journal of Molecular Sciencesen_US
dc.subjectArtemether-lumefantrineen_US
dc.subjectMalien_US
dc.subjectPfcrten_US
dc.subjectPfmdr1en_US
dc.subjectPlasmodium falciparumen_US
dc.titleSelection of pfcrt k76 and pfmdr1 n86 coding alleles after uncomplicated malaria treatment by artemether-lumefantrine in Malien_US
dc.typeArticleen_US
dc.identifier.doi10.3390/ijms22116057
dc.source.volume22
dc.source.issue11


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