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2.
Proc Biol Sci ; 290(1995): 20230117, 2023 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-36987649

RESUMO

A common assumption in the evolution of virulence theory literature is that pathogens transmit better when they exploit their host more heavily, but by doing so, they impose a greater risk of killing their host, thus truncating infectious periods and reducing their own opportunities for transmission. Here, I derive an equation for the magnitude of this cost in terms of the infection fatality rate, and in doing so, I show that there are many cases where mortality costs are too small to plausibly constrain increases in host exploitation by pathogens. I propose that pathogen evolution may often be constrained by detection costs, whereby hosts alter their behaviour when infection is detectable, and thus reduce pathogen opportunities for onward transmission. I then derive an inequality to illustrate when mortality costs or detection costs impose stronger constraints on pathogen evolution, and I use empirical data from the literature to demonstrate that detection costs are frequently large in both human and animal populations. Finally, I give examples of how evolutionary predictions can change depending on whether costs of host exploitation are borne out through mortality or detection.


Assuntos
Evolução Biológica , Interações Hospedeiro-Patógeno , Animais , Humanos , Virulência , Modelos Biológicos
3.
PLoS Biol ; 20(9): e3001804, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36149891

RESUMO

Following the initiation of the unprecedented global vaccination campaign against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), attention has now turned to the potential impact of this large-scale intervention on the evolution of the virus. In this Essay, we summarize what is currently known about pathogen evolution in the context of immune priming (including vaccination) from research on other pathogen species, with an eye towards the future evolution of SARS-CoV-2.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/prevenção & controle , Humanos , Programas de Imunização , Vacinação
4.
Proc Biol Sci ; 289(1983): 20221165, 2022 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-36126684

RESUMO

A lack of tractable experimental systems in which to test hypotheses about the ecological and evolutionary drivers of disease spillover and emergence has limited our understanding of these processes. Here we introduce a promising system: Caenorhabditis hosts and Orsay virus, a positive-sense single-stranded RNA virus that naturally infects C. elegans. We assayed species across the Caenorhabditis tree and found Orsay virus susceptibility in 21 of 84 wild strains belonging to 14 of 44 species. Confirming patterns documented in other systems, we detected effects of host phylogeny on susceptibility. We then tested whether susceptible strains were capable of transmitting Orsay virus by transplanting exposed hosts and determining whether they transmitted infection to conspecifics during serial passage. We found no evidence of transmission in 10 strains (virus undetectable after passaging in all replicates), evidence of low-level transmission in 5 strains (virus lost between passage 1 and 5 in at least one replicate) and evidence of sustained transmission in 6 strains (including all three experimental C. elegans strains) in at least one replicate. Transmission was strongly associated with viral amplification in exposed populations. Variation in Orsay virus susceptibility and transmission among Caenorhabditis strains suggests that the system could be powerful for studying spillover and emergence.


Assuntos
Caenorhabditis , Nodaviridae , Vírus , Animais , Caenorhabditis elegans/genética , Especificidade de Hospedeiro , Nodaviridae/genética
5.
PLoS Biol ; 19(11): e3001409, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34784349

RESUMO

Humans are altering biological systems at unprecedented rates, and these alterations often have longer-term evolutionary impacts. Most obvious is the spread of resistance to pesticides and antibiotics. There are a wide variety of management strategies available to slow this evolution, and there are many reasons for using them. In this paper, we focus on the economic aspects of evolution management and ask: When is it economically beneficial for an individual decision-maker to invest in evolution management? We derive a simple dimensionless inequality showing that it is cost-effective to manage evolution when the percentage increase in the effective life span of the biological resource that management generates is larger than the percentage increase in annual profit that could be obtained by not managing evolution. We show how this inequality can be used to determine optimal investment choices for single decision-makers, to determine Nash equilibrium investment choices for multiple interacting decision-makers, and to examine how these equilibrium choices respond to regulatory interventions aimed at stimulating investment in evolution management. Our results are illustrated with examples involving Bacillus thuringiensis (Bt) crops and antibiotic use in fish farming.


Assuntos
Evolução Biológica , Bacillus thuringiensis , Modelos Biológicos , Plantas Geneticamente Modificadas , Zea mays/genética
6.
Theor Popul Biol ; 137: 2-9, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33417839

RESUMO

The reproductive number R (or R0, the initial reproductive number in an immune-naïve population) has long been successfully used to predict the likelihood of pathogen invasion, to gauge the potential severity of an epidemic, and to set policy around interventions. However, often ignored complexities have generated confusion around use of the metric. This is particularly apparent with the emergent pandemic virus SARS-CoV-2, the causative agent of COVID-19. We address some misconceptions about the predictive ability of the reproductive number, focusing on how it changes over time, varies over space, and relates to epidemic size by referencing the mathematical definition of R and examples from the current pandemic. We hope that a better appreciation of the uses, nuances, and limitations of R and R0 facilitates a better understanding of epidemic spread, epidemic severity, and the effects of interventions in the context of SARS-CoV-2.


Assuntos
Número Básico de Reprodução , COVID-19 , Número Básico de Reprodução/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/transmissão , Previsões , Humanos , Modelos Estatísticos , Pandemias , Saúde da População , SARS-CoV-2/isolamento & purificação , Estados Unidos/epidemiologia
7.
PLoS Biol ; 18(11): e3001000, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33166303

RESUMO

Although less common than the evolution of antimicrobial drug resistance, vaccine resistance can and has evolved. How likely is it that COVID-19 vaccines currently in development will be undermined by viral evolution? We argue that this can be determined by repurposing samples that are already being collected as part of clinical trials. Such information would be useful for prioritizing investment among candidate vaccines and maximizing the potential long-term impact of COVID-19 vaccines.


Assuntos
Betacoronavirus/imunologia , Ensaios Clínicos como Assunto , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Farmacorresistência Viral/imunologia , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Vacinas Virais/imunologia , COVID-19 , Vacinas contra COVID-19 , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias , Fatores de Risco , SARS-CoV-2
8.
Virus Evol ; 5(1): vey042, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31024735

RESUMO

The evolution of Marek's disease virus (MDV, Gallid herpesvirus 2) has threatened the sustainability of poultry farming in the past and its continued evolution remains a concern. Genetic diversity is key to understanding evolution, yet little is known about the diversity of MDV in the poultry industry. Here, we investigate the diversity of MDV on 19 Pennsylvanian poultry farms over a 3-year period. Using eight polymorphic markers, we found that at least twelve MDV haplotypes were co-circulating within a radius of 40 km. MDV diversity showed no obvious spatial clustering nor any apparent clustering by bird line: all of the virus haplotypes identified on the commercial farms could be found within a single, commonly reared bird line. On some farms, a single virus haplotype dominated for an extended period of time, while on other farms the observed haplotypes changed over time. In some instances, multiple haplotypes were found simultaneously on a farm, and even within a single dust sample. On one farm, co-occurring haplotypes clustered into phylogenetically distinct clades, putatively assigned as high and low virulence pathotypes. Although the vast majority of our samples came from commercial poultry farms, we found the most haplotype diversity on a noncommercial backyard farm experiencing an outbreak of clinical Marek's disease. Future work to explore the evolutionary potential of MDV might therefore direct efforts toward farms that harbor multiple virus haplotypes, including both backyard farms and farms experiencing clinical Marek's disease.

9.
Proc Natl Acad Sci U S A ; 115(51): 12878-12886, 2018 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-30559199

RESUMO

Vaccines and antimicrobial drugs both impose strong selection for resistance. Yet only drug resistance is a major challenge for 21st century medicine. Why is drug resistance ubiquitous and not vaccine resistance? Part of the answer is that vaccine resistance is far less likely to evolve than drug resistance. But what happens when vaccine resistance does evolve? We review six putative cases. We find that in contrast to drug resistance, vaccine resistance is harder to detect and harder to confirm and that the mechanistic basis is less well understood. Nevertheless, in the cases we examined, the pronounced health benefits associated with vaccination have largely been sustained. Thus, we contend that vaccine resistance is less of a concern than drug resistance because it is less likely to evolve and when it does, it is less harmful to human and animal health and well-being. Studies of pathogen strains that evolve the capacity to replicate and transmit from vaccinated hosts will enhance our ability to develop next-generation vaccines that minimize the risk of harmful pathogen evolution.


Assuntos
Resistência Microbiana a Medicamentos , Imunoterapia Ativa , Animais , Resistência a Medicamentos , Vírus da Hepatite B/imunologia , Humanos , Mardivirus/imunologia , Metapneumovirus/imunologia , Streptococcus pneumoniae/imunologia
10.
PLoS Biol ; 16(3): e2004444, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29590105

RESUMO

Changes in pathogen genetic variation within hosts alter the severity and spread of infectious diseases, with important implications for clinical disease and public health. Genetic drift may play a strong role in shaping pathogen variation, but analyses of drift in pathogens have oversimplified pathogen population dynamics, either by considering dynamics only at a single scale-such as within hosts or between hosts-or by making drastic simplifying assumptions, for example, that host immune systems can be ignored or that transmission bottlenecks are complete. Moreover, previous studies have used genetic data to infer the strength of genetic drift, whereas we test whether the genetic drift imposed by pathogen population processes can be used to explain genetic data. We first constructed and parameterized a mathematical model of gypsy moth baculovirus dynamics that allows genetic drift to act within and between hosts. We then quantified the genome-wide diversity of baculovirus populations within each of 143 field-collected gypsy moth larvae using Illumina sequencing. Finally, we determined whether the genetic drift imposed by host-pathogen population dynamics in our model explains the levels of pathogen diversity in our data. We found that when the model allows drift to act at multiple scales-including within hosts, between hosts, and between years-it can accurately reproduce the data, but when the effects of drift are simplified by neglecting transmission bottlenecks and stochastic variation in virus replication within hosts, the model fails. A de novo mutation model and a purifying selection model similarly fail to explain the data. Our results show that genetic drift can play a strong role in determining pathogen variation and that mathematical models that account for pathogen population growth at multiple scales of biological organization can be used to explain this variation.


Assuntos
Baculoviridae/genética , Deriva Genética , Interações Hospedeiro-Patógeno/genética , Mariposas/virologia , Animais , Baculoviridae/fisiologia , DNA Viral/química , Variação Genética , Modelos Teóricos , Análise de Sequência de DNA , Processos Estocásticos
11.
Epidemics ; 23: 85-95, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29366873

RESUMO

Marek's disease virus (MDV) is a pathogen of chickens whose control has twice been undermined by pathogen evolution. Disease ecology is believed to be the main driver of this evolution, yet mathematical models of MDV disease ecology have never been confronted with data to test their reliability. Here, we develop a suite of MDV models that differ in the ecological mechanisms they include. We fit these models with maximum likelihood using iterated filtering in 'pomp' to data on MDV concentration in dust collected from two commercial broiler farms. We find that virus dynamics are influenced by between-flock variation in host susceptibility to virus, shedding rate from infectious birds, and cleanout efficiency. We also find evidence that virus is reintroduced to farms approximately once per month, but we do not find evidence that virus sanitization rates vary between flocks. Of the models that survive model selection, we find agreement between parameter estimates and previous experimental data, as well as agreement between field data and the predictions of these models. Using the set of surviving models, we explore how changes to farming practices are predicted to influence MDV-associated condemnation risk (production losses at slaughter). By quantitatively capturing the mechanisms of disease ecology, we have laid the groundwork to explore the future trajectory of virus evolution.


Assuntos
Agricultura/métodos , Doença de Marek/transmissão , Animais , Galinhas/virologia , Modelos Animais de Doenças , Reprodutibilidade dos Testes
12.
Avian Dis ; 61(2): 153-164, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28665725

RESUMO

Marek's disease virus is a herpesvirus of chickens that costs the worldwide poultry industry more than US$1 billion annually. Two generations of Marek's disease vaccines have shown reduced efficacy over the last half century due to evolution of the virus. Understanding where the virus is present may give insight into whether continued reductions in efficacy are likely. We conducted a 3-yr surveillance study to assess the prevalence of Marek's disease virus on commercial poultry farms, determine the effect of various factors on virus prevalence, and document virus dynamics in broiler chicken houses over short (weeks) and long (years) timescales. We extracted DNA from dust samples collected from commercial chicken and egg production facilities in Pennsylvania, USA. Quantitative PCR was used to assess wild-type virus detectability and concentration. Using data from 1018 dust samples with Bayesian generalized linear mixed effects models, we determined the factors that correlated with virus prevalence across farms. Maximum likelihood and autocorrelation function estimation on 3727 additional dust samples were used to document and characterize virus concentrations within houses over time. Overall, wild-type virus was detectable at least once on 36 of 104 farms at rates that varied substantially between farms. Virus was detected in one of three broiler-breeder operations (companies), four of five broiler operations, and three of five egg layer operations. Marek's disease virus detectability differed by production type, bird age, day of the year, operation (company), farm, house, flock, and sample. Operation (company) was the most important factor, accounting for between 12% and 63.4% of the variation in virus detectability. Within individual houses, virus concentration often dropped below detectable levels and reemerged later. These data characterize Marek's disease virus dynamics, which are potentially important to the evolution of the virus.


Assuntos
Herpesvirus Galináceo 2/isolamento & purificação , Doença de Marek/virologia , Doenças das Aves Domésticas/virologia , Vigilância de Evento Sentinela/veterinária , Criação de Animais Domésticos/economia , Animais , Galinhas , Fazendas , Genótipo , Herpesvirus Galináceo 2/classificação , Herpesvirus Galináceo 2/genética , Doença de Marek/economia , Doença de Marek/epidemiologia , Pennsylvania , Doenças das Aves Domésticas/economia , Doenças das Aves Domésticas/epidemiologia
13.
Proc Biol Sci ; 284(1851)2017 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-28356449

RESUMO

Why is drug resistance common and vaccine resistance rare? Drugs and vaccines both impose substantial pressure on pathogen populations to evolve resistance and indeed, drug resistance typically emerges soon after the introduction of a drug. But vaccine resistance has only rarely emerged. Using well-established principles of population genetics and evolutionary ecology, we argue that two key differences between vaccines and drugs explain why vaccines have so far proved more robust against evolution than drugs. First, vaccines tend to work prophylactically while drugs tend to work therapeutically. Second, vaccines tend to induce immune responses against multiple targets on a pathogen while drugs tend to target very few. Consequently, pathogen populations generate less variation for vaccine resistance than they do for drug resistance, and selection has fewer opportunities to act on that variation. When vaccine resistance has evolved, these generalities have been violated. With careful forethought, it may be possible to identify vaccines at risk of failure even before they are introduced.


Assuntos
Resistência Microbiana a Medicamentos , Evolução Molecular , Vacinas
14.
mSphere ; 1(5)2016.
Artigo em Inglês | MEDLINE | ID: mdl-27747299

RESUMO

The intensification of the poultry industry over the last 60 years facilitated the evolution of increased virulence and vaccine breaks in Marek's disease virus (MDV-1). Full-genome sequences are essential for understanding why and how this evolution occurred, but what is known about genome-wide variation in MDV comes from laboratory culture. To rectify this, we developed methods for obtaining high-quality genome sequences directly from field samples without the need for sequence-based enrichment strategies prior to sequencing. We applied this to the first characterization of MDV-1 genomes from the field, without prior culture. These viruses were collected from vaccinated hosts that acquired naturally circulating field strains of MDV-1, in the absence of a disease outbreak. This reflects the current issue afflicting the poultry industry, where virulent field strains continue to circulate despite vaccination and can remain undetected due to the lack of overt disease symptoms. We found that viral genomes from adjacent field sites had high levels of overall DNA identity, and despite strong evidence of purifying selection, had coding variations in proteins associated with virulence and manipulation of host immunity. Our methods empower ecological field surveillance, make it possible to determine the basis of viral virulence and vaccine breaks, and can be used to obtain full genomes from clinical samples of other large DNA viruses, known and unknown. IMPORTANCE Despite both clinical and laboratory data that show increased virulence in field isolates of MDV-1 over the last half century, we do not yet understand the genetic basis of its pathogenicity. Our knowledge of genome-wide variation between strains of this virus comes exclusively from isolates that have been cultured in the laboratory. MDV-1 isolates tend to lose virulence during repeated cycles of replication in the laboratory, raising concerns about the ability of cultured isolates to accurately reflect virus in the field. The ability to directly sequence and compare field isolates of this virus is critical to understanding the genetic basis of rising virulence in the wild. Our approaches remove the prior requirement for cell culture and allow direct measurement of viral genomic variation within and between hosts, over time, and during adaptation to changing conditions.

15.
Evol Appl ; 9(2): 344-54, 2016 02.
Artigo em Inglês | MEDLINE | ID: mdl-26834829

RESUMO

Infectious diseases are economically detrimental to aquaculture, and with continued expansion and intensification of aquaculture, the importance of managing infectious diseases will likely increase in the future. Here, we use evolution of virulence theory, along with examples, to identify aquaculture practices that might lead to the evolution of increased pathogen virulence. We identify eight practices common in aquaculture that theory predicts may favor evolution toward higher pathogen virulence. Four are related to intensive aquaculture operations, and four others are related specifically to infectious disease control. Our intention is to make aquaculture managers aware of these risks, such that with increased vigilance, they might be able to detect and prevent the emergence and spread of increasingly troublesome pathogen strains in the future.

16.
PLoS Biol ; 13(7): e1002198, 2015 07.
Artigo em Inglês | MEDLINE | ID: mdl-26214839

RESUMO

Could some vaccines drive the evolution of more virulent pathogens? Conventional wisdom is that natural selection will remove highly lethal pathogens if host death greatly reduces transmission. Vaccines that keep hosts alive but still allow transmission could thus allow very virulent strains to circulate in a population. Here we show experimentally that immunization of chickens against Marek's disease virus enhances the fitness of more virulent strains, making it possible for hyperpathogenic strains to transmit. Immunity elicited by direct vaccination or by maternal vaccination prolongs host survival but does not prevent infection, viral replication or transmission, thus extending the infectious periods of strains otherwise too lethal to persist. Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts.


Assuntos
Mardivirus/patogenicidade , Vacinas contra Doença de Marek/efeitos adversos , Doença de Marek/transmissão , Seleção Genética , Animais , Galinhas , Mardivirus/genética , Doença de Marek/imunologia , Eliminação de Partículas Virais
17.
Prev Vet Med ; 120(3-4): 328-35, 2015 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-25998661

RESUMO

Marek's disease, a disease primarily affecting immature chickens, is a worldwide problem that has on at least three occasions threatened the poultry industry in the United States. A rich dataset to study the epidemiology of this disease is available because the United States Department of Agriculture has required mandatory inspections of all commercially sold poultry of significant scale since the mid-20th century with over 99% of all chickens inspected. This dataset includes monthly totals aggregated by state since 1961 of the number of "young chickens" inspected and the number with "leukosis", a condemnation category that is almost always associated with Marek's disease in this category of birds. The objective of this study was to analyze temporal and spatial patterns in this condemnation data to gain insight into the ecology and epidemiology of the causative virus. We extracted visual patterns in the data using seasonal trend decomposition, and we tested for statistical significance using extended linear modeling techniques. The analysis confirmed previous findings that there are differences in leukosis condemnation rates between states, across years, and within years. The analysis also revealed several patterns not previously highlighted, including spatial and temporal autocorrelations in leukosis condemnation, changes to the amplitude of seasonality over time, and increasing within-year variation in condemnation rate over time. These patterns suggest that locally shared farm practices, virus transmission between farms, or viral persistence may be important to understanding the dynamics of the disease. We also discuss the plausibility of other potential explanations for these patterns.


Assuntos
Criação de Animais Domésticos , Galinhas , Doença de Marek/epidemiologia , Doenças das Aves Domésticas/epidemiologia , Animais , Leucose Aviária , Geografia , Incidência , Doença de Marek/virologia , Doenças das Aves Domésticas/virologia , Prevalência , Estações do Ano , Análise Espacial , Estados Unidos/epidemiologia
18.
Am Nat ; 184(3): 407-23, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25141148

RESUMO

Pathogen population dynamics within individual hosts can alter disease epidemics and pathogen evolution, but our understanding of the mechanisms driving within-host dynamics is weak. Mathematical models have provided useful insights, but existing models have only rarely been subjected to rigorous tests, and their reliability is therefore open to question. Most models assume that initial pathogen population sizes are so large that stochastic effects due to small population sizes, so-called demographic stochasticity, are negligible, but whether this assumption is reasonable is unknown. Most models also assume that the dynamic effects of a host's immune system strongly affect pathogen incubation times or "response times," but whether such effects are important in real host-pathogen interactions is likewise unknown. Here we use data for a baculovirus of the gypsy moth to test models of within-host pathogen growth. By using Bayesian statistical techniques and formal model-selection procedures, we are able to show that the response time of the gypsy moth virus is strongly affected by both demographic stochasticity and a dynamic response of the host immune system. Our results imply that not all response-time variability can be explained by host and pathogen variability, and that immune system responses to infection may have important effects on population-level disease dynamics.


Assuntos
Baculoviridae/crescimento & desenvolvimento , Interações Hospedeiro-Patógeno/fisiologia , Mariposas/imunologia , Mariposas/virologia , Animais , Teorema de Bayes , Modelos Teóricos , Dinâmica Populacional , Fatores de Tempo
19.
Am Nat ; 184 Suppl 1: S47-57, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25061677

RESUMO

Host immunity plays an important role in the evolution of pathogen virulence and disease emergence. There is increasing theoretical and empirical evidence that enhanced immunity through vaccination may have the unfortunate side effect of selecting for more virulent parasites, but the effect of host immune suppression on pathogen evolution is less clear. Here, we use serial passage experiments in mice to test how immune-suppressed hosts may alter pathogen virulence evolution. We passaged Plasmodium chabaudi through CD4(+) T cell-depleted or control mice every 7 days for 20 weeks and then measured virulence differences during infection of immunologically normal mice. We found that those parasites that had been selected through CD4(+) T cell-depleted mice were more virulent than parasites selected through control mice. Virulence increases during serial passage are believed to be caused by pathogen adaptation to the passage host. These data suggest that immune-suppressed hosts could provide a within-host environment that lowers the barrier to parasite adaptation and promotes the evolution of virulence.


Assuntos
Evolução Biológica , Malária/imunologia , Malária/parasitologia , Plasmodium chabaudi/patogenicidade , Animais , Linfócitos T CD4-Positivos/fisiologia , Feminino , Interações Hospedeiro-Parasita , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Parasitos , Virulência
20.
Trends Parasitol ; 29(7): 321-8, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23746748

RESUMO

Drug resistance is a major obstacle to controlling infectious diseases. A key challenge is detecting the early signs of drug resistance when little is known about its genetic basis. Focusing on malaria parasites, we propose a way to do this. Newly developing or low level resistance at low frequency in patients can be detected through a phenotypic signature: individual parasite variants clearing more slowly following drug treatment. Harnessing the abundance and resolution of deep sequencing data, our 'selection differential' approach addresses some limitations of extant methods of resistance detection, should allow for the earliest detection of resistance in malaria or other multi-clone infections, and has the power to uncover the true scale of the drug resistance problem.


Assuntos
Antimaláricos/farmacologia , Monitoramento de Medicamentos/métodos , Resistência a Medicamentos , Malária/tratamento farmacológico , Plasmodium falciparum/efeitos dos fármacos , Animais , Antimaláricos/uso terapêutico , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Malária/parasitologia , Fenótipo , Plasmodium falciparum/genética , Análise de Sequência de DNA
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