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Mathematical modeling can help guide the selection of malaria control and elimination strategies.
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How will we handle the access to artesunate treatment of colorectal cancer patients in countries such as Kenya, Thailand and Indonesia to limit the risk of selection of malaria-resistant parasites in asymptomatic carriers?
This study compares population structure and genomic signatures of selection on malaria parasites in two closely situated but ecologically contrasting endemic areas.
Haplotype based tests of directional selection on malaria parasites in West Africa have previously identified selection occurring over very recent time frames, with strong signatures linked to the use of chloroquine and the antifolate drugs sulphadoxine-pyrimethamine as first line malaria therapies [ 17, 19, 22].
The strong protection against severe malaria conferred by the HbS [7], G6PD [9], [10] [10] and the alpha-thalassemia mutations [11], [12], [13] illustrate the striking selection pressure of malaria on the human genome.
These inherent sources include selection of no malaria controls from a hospital setting which may have affected our results.
In general, the sequence of drug resistance in this lineage reflects the historical pattern of selection of human malaria parasites by drug prophylaxis and treatment.
Patient adherence to treatment is an important step in ensuring the effectiveness of artemisinin-based combination therapies (ACTs) for malaria. 1 Incomplete adherence to recommended treatment can result in poor clinical outcomes, undermine the effectiveness of case management as a tool for malaria control, and may contribute to the selection of drug-resistant malaria parasites.
Vallée du Kou is surrounded by agricultural land which has long been exposed to pesticides, contributing to the selection of resistance in malaria vectors (Diabate et al., 2002a).
In future, haplotype-level analyses of larger sample sets as RTS,S vaccines enter Phase III testing may help to establish whether any observed individual amino acid changes in breakthrough parasites represent the beginning of vaccine-dependent cumulative selection for escape mutants of malaria parasites.
Hypothetically, the expansion of 1264G alleles in the Yoruba could represent a local selection event on top of a low-level background of selection by malaria.
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