Fig. 1: Susceptibility assessment of isolates groups to PPQ, MQ and MQ-PPQ.
In vitro susceptibility of sensitive (sensitive, n = 5, green), PPQ-resistant (KEL1/PLA1, n = 9, blue) and MQ-resistant (MQ-R, n = 17, yellow) parasites to PPQ (A), MQ (B), and paired MQ–PPQ (C). Mean and standard deviation are shown on the graphs. Kruskal–Wallis followed by Dunn’s multiple comparison test or ordinary one-way ANOVA followed by Tukey’s or Dunnett’s T3 multiple comparison tests were used for statistical analysis. P-values are based on two-sided tests. A Susceptibility of clinical isolates to PPQ measured by PSA. KEL1/PLA1 isolates have a significantly higher survival rate than both Sensitive (*** p = 0.0003) and MQ-R parasites (**** p = 5.00 × 10−5). Shapiro–Wilk test confirmed normality for the KEL1/PLA1 group (p = 0.9503) but not for MQ-R group (**** p = 2.00 × 10−6). B Susceptibility of clinical isolates to MQ measured by [³H]-hypoxanthine incorporation. MQ-R isolates have significantly higher IC50s than both Sensitive (**** p = 3.70 × 10−5) and KEL1/PLA1 parasites (**** p = 3.00 × 10−8). Shapiro–Wilk test p-values were 0.1370 (Sensitive), 0.6103 (KEL1/PLA1), and 0.1747 (MQ-R). C Susceptibility of clinical isolates to PPQ and MQ co-exposure. Survival IC50s were calculated after measuring the survival rate of parasites at increasing concentrations of MQ–PPQ combination. MQ-R isolates exhibited significantly higher Survival IC50s than both Sensitive (**** p = 5.00 × 10−⁶) and KEL1/PLA1 parasites (**** p = 2.40 × 10−5). Shapiro–Wilk test p-values were 0.5980 (Sensitive), 0.4375 (KEL1/PLA1), and 0.5649 (MQ-R). D Correlation between MQ IC50 and MQ–PPQ Survival IC50. The IC50s of MQ and the Survival IC50s of the combination MQ–PPQ exposure were highly correlated (r = 0.7347, **** p = 2.53 × 10−⁶ Spearman correlation test, Shapiro-Wilk test for normality gave * p value = 0.0350). Source data are provided as a Source Data file.
