ArticleAntimicrobial agents and chemotherapy2015
Artemisinin resistance at the China-Myanmar border and association with mutations in the K13 propeller gene.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
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Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- K13-propeller gene polymorphisms in Plasmodium falciparum parasite population in malaria affected countries: a systematic review of prevalence and risk factors.Malaria journal · 2019Pooled it
- Pooled it
- Analysis of anti-malarial resistance markers in pfmdr1 and pfcrt across Southeast Asia in the Tracking Resistance to Artemisinin Collaboration.Malaria journal · 2016Trial
- Drug resistance gene polymorphisms of Plasmodium falciparum clinical isolates from Kinshasa, Democratic Republic of the Congo.Tropical medicine and health · 2026Article
- Double Mutations inbioRxiv : the preprint server for biology · 2026Article
- In vitro delayed response to dihydroartemisinin of malaria parasites infecting sickle cell erythocytes.Malaria journal · 2024Article
- Mapping the genomic landscape of multidrug resistance inScience advances · 2023Article
- Article
- Different In Vitro Drug Susceptibility Profile ofTropical medicine and infectious disease · 2022Article
- Multidisciplinary Investigations of Sustained Malaria Transmission in the Greater Mekong Subregion.The American journal of tropical medicine and hygiene · 2022Article
- Lessons for improved COVID-19 surveillance from the scale-up of malaria testing strategies.Malaria journal · 2022Review
- An analysis ofJournal of parasitic diseases : official organ of the Indian Society for Parasitology · 2022Review
- Artemisinin resistance and malaria elimination: Where are we now?Frontiers in pharmacology · 2022Review
- Kelch13 mutations in Plasmodium falciparum and risk of spreading in Amazon basin countries.The Journal of antimicrobial chemotherapy · 2021Article
- Molecular surveillance of drug resistance: Plasmodium falciparum artemisinin resistance single nucleotide polymorphisms in Kelch protein propeller (K13) domain from Southern Pakistan.Malaria journal · 2021Article
- Plasmodium berghei K13 Mutations MediatemBio · 2020Article
- Efficacy of Artemether-Lumefantrine on variousParasite epidemiology and control · 2020Article
- Evolution of Antimalarial Drug Resistance Markers in the Reservoir of Plasmodium falciparum Infections in the Upper East Region of Ghana.The Journal of infectious diseases · 2020Article
- Genetic screens reveal a central role for heme metabolism in artemisinin susceptibility.Nature communications · 2020Article
- Efficacy of artemether-lumefantrine for treating uncomplicated Plasmodium falciparum cases and molecular surveillance of drug resistance genes in Western Myanmar.Malaria journal · 2020Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 2 countries.
Funding
Abstract
Artemisinin resistance in Plasmodium falciparum parasites in Southeast Asia is a major concern for malaria control. Its emergence at the China-Myanmar border, where there have been more than 3 decades of artemisinin use, has yet to be investigated. Here, we comprehensively evaluated the potential emergence of artemisinin resistance and antimalarial drug resistance status in P. falciparum using data and parasites from three previous efficacy studies in this region. These efficacy studies of dihydroartemisinin-piperaquine combination and artesunate monotherapy of uncomplicated falciparum malaria in 248 P. falciparum patients showed an overall 28-day adequate clinical and parasitological response of >95% and day 3 parasite-positive rates of 6.3 to 23.1%. Comparison of the 57 K13 sequences (24 and 33 from day 3 parasite-positive and -negative cases, respectively) identified nine point mutations in 38 (66.7%) samples, of which F446I (49.1%) and an N-terminal NN insertion (86.0%) were predominant. K13 propeller mutations collectively, the F446I mutation alone, and the NN insertion all were significantly associated with day 3 parasite positivity. Increased ring-stage survival determined using the ring-stage survival assay (RSA) was highly associated with the K13 mutant genotype. Day 3 parasite-positive isolates had ∼10 times higher ring survival rates than day 3 parasite-negative isolates. Divergent K13 mutations suggested independent evolution of artemisinin resistance. Taken together, this study confirmed multidrug resistance and emergence of artemisinin resistance in P. falciparum at the China-Myanmar border. RSA and K13 mutations are useful phenotypic and molecular markers for monitoring artemisinin resistance.
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