Fig. 1

Workflow for testing adaptability of Plasmodium falciparum parasites from patients. Between 3 and 6 ml of blood was collected from each enrolled patient infected with P. falciparum or mixed co-infection with P. vivax. For direct culture (left path), aliquots of infected blood were used to establish 8 cultures under different conditions (See “Methods” and Table 1). For the adaptation from cryopreserved samples (right path), two independent researchers each thawed cryogenically preserved patient isolate samples in duplicate. When two cultures reached 0.5–1.0 %, two growth tests were conducted. Parasite cultures were maintained for as long as 35 days for adaptation from freshly drawn blood and as long as 45 days to allow adaptation from cryopreserved blood