Artemisinin-Resistant Plasmodium falciparum with High Survival Rates, Uganda, 2014–2016
Mie Ikeda, Megumi Kaneko, Shin-Ichiro Tachibana, Betty Balikagala, Miki Sakurai-Yatsushiro, Shouki Yatsushiro, Nobuyuki Takahashi, Masato Yamauchi, Makoto Sekihara, Muneaki Hashimoto
1, Osbert T. Katuro
2, Alex Olia
3, Paul S. Obwoya, Mary A. Auma, Denis A. Anywar, Emmanuel I. Odongo-Aginya, Joseph Okello-Onen
4, Makoto Hirai, Jun Ohashi, Nirianne M.Q. Palacpac, Masatoshi Kataoka, Takafumi Tsuboi, Eisaku Kimura, Toshihiro Horii, and Toshihiro Mita
Author affiliations: Juntendo University School of Medicine, Tokyo, Japan (M. Ikeda, M. Kaneko, S.-I. Tachibana, M. Yamauchi, M. Sekihara, M. Hashimoto, M. Hirai, T. Mita); Ehime University, Matsuyama, Japan (B. Balikagala, T. Tsuboi); Tokyo Women’s Medical University, Tokyo (M. Sakurai-Yatsushiro, N. Takahashi); National Institute of Advanced Industrial Science and Technology, Kagawa, Japan (S. Yatsushiro, M. Kataoka); Med Biotech Laboratories, Kampala, Uganda (O.T. Katuro); Gulu University, Gulu, Uganda (A. Olia, D.A. Anywar, E.I. Odongo-Aginya, J. Okello-Onen); St. Mary’s Hospital Lacor, Gulu (P.S. Obwoya, M.A. Auma); The University of Tokyo, Tokyo (J. Ohashi); Osaka University, Osaka, Japan (N.M.Q. Palacpac, E. Kimura, T. Horii)
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Figure 3
Figure 3. Distribution of IC50 of Plasmodium falciparum values by dihydroartemisinin in conventional ex vivo drug susceptibility assay. IC50 values to dihydroartemisinin in conventional ex vivo drug susceptibility assay are plotted. Geometric mean IC50 values in isolates with survival rates of 0, >0 to <10%, and >10% (high RSA survival) were 3.0 nmol/L (n = 74), 1.9 nmol/L (n = 14), and 3.3 nmol/L (n = 3), respectively. In the conventional ex vivo drug susceptibility assay, replication of parasites was monitored after continuous exposure to dihydroartemisinin for 72 h. Dashed line indicates geometric mean IC50 value of all isolates (2.25 nmol/L). IC50, concentration needed to inhibit 50% growth; RSA, ring-stage survival assay.
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