ArticleThe Journal of infectious diseases2019
Artemisinin Resistance and Stage Dependency of Parasite Clearance in Falciparum Malaria.
Article in The Journal of infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Contribution of Functional Antimalarial Immunity to Measures of Parasite Clearance in Therapeutic Efficacy Studies of Artemisinin Derivatives.The Journal of infectious diseases · 2019Trial
- Single-cell transcriptional changes across the blood stages of artemisinin-resistant K13bioRxiv : the preprint server for biology · 2025Article
- Expansion of theOpen forum infectious diseases · 2025Article
- Detection of novelMicrobial genomics · 2025Article
- Artemisinin-resistant malaria.Clinical microbiology reviews · 2024Review
- Identification of anFrontiers in parasitology · 2023Article
- Severe malaria.Malaria journal · 2022Review
- Comparison of Antibody Responses and Parasite Clearance in Artemisinin Therapeutic Efficacy Studies in the Democratic Republic of Congo and Asia.The Journal of infectious diseases · 2022Article
- The assessment of antimalarial drug efficacy in vivo.Trends in parasitology · 2022Review
- Article
- Artemisinin resistance and malaria elimination: Where are we now?Frontiers in pharmacology · 2022Review
- Plasmodium falciparum clearance time in Malawian children with cerebral malaria: a retrospective cohort study.Malaria journal · 2021Article
- Questioning the Claimed Superiority of Malaria Parasite Ex Vivo Viability Reduction Over Observed Parasite Clearance Rate?The Journal of infectious diseases · 2021Article
- Novel Antimalarial Tetrazoles and Amides Active against the Hemoglobin Degradation Pathway inJournal of medicinal chemistry · 2021Article
- Daily rhythms of both host and parasite affect antimalarial drug efficacy.Evolution, medicine, and public health · 2021Article
- Antimalarial Drug Resistance and Implications for the WHO Global Technical Strategy.Current epidemiology reports · 2021Review
- Therapeutic Efficacy of Artemether-Lumefantrine for Uncomplicated Falciparum Malaria in Northern Zambia.The American journal of tropical medicine and hygiene · 2020Article
- Hybrid Gold(I) NHC-Artemether Complexes to Target Falciparum Malaria Parasites.Molecules (Basel, Switzerland) · 2020Article
Corrections and comments
- Erratum issuedErrata.2019
Authors and funding
13 authors.
Funding
Abstract
backgroundArtemisinin resistance in falciparum malaria is associated with kelch13 propeller mutations, reduced ring stage parasite killing, and, consequently, slow parasite clearance. We assessed how parasite age affects parasite clearance in artemisinin resistance.
methodsDevelopmental stages of Plasmodium falciparum parasites on blood films performed at hospital admission and their kelch13 genotypes were assessed for 816 patients enrolled in a multinational clinical trial of artemisinin combination therapy.
resultsEarly changes in parasitemia level (ie, 0-6 hours after admission) were determined mainly by modal stage of asexual parasite development, whereas the subsequent log-linear decline was determined mainly by kelch13 propeller mutations. Older circulating parasites on admission were associated with more-rapid parasite clearance, particularly in kelch13 mutant infections. The geometric mean parasite clearance half-life decreased by 11.6% (95% CI 3.4%-19.1%) in kelch13 wild-type infections and by 30% (95% CI 17.8%-40.4%) in kelch13 mutant infections as the mean age of circulating parasites rose from 3 to 21 hours.
conclusionFollowing the start of antimalarial treatment, ongoing parasite sequestration and schizogony both affect initial changes in parasitemia. The greater dependency of parasite clearance half-life on parasite age in artemisinin resistant infections is consistent with ring stage resistance and consequent parasite clearance by sequestration. The stage of parasite development should be incorporated in individual assessments of artemisinin resistance.
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