ArticleThe Lancet. Infectious diseases2024
Impact of piperaquine resistance in Plasmodium falciparum on malaria treatment effectiveness in The Guianas: a descriptive epidemiological study.
Article in The Lancet. Infectious diseases, 2024. 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 29 papers.
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29 citing papers in PubMed, 35 citations in OpenAlex.
- Identification of an Orally Efficacious Imidazo[4,5-Journal of medicinal chemistry · 2026Article
- Global-scale population genetic analysis of Plasmodium falciparum identifies region-specific patterns of malaria parasite adaptation.Nature communications · 2026Article
- Application Strategy and Research Progress of Large-Scale Population Drug Intervention in Malaria Control.Tropical medicine and infectious disease · 2026Review
- Emergence of artemisinin-based combination therapy resistance markers inAntimicrobial agents and chemotherapy · 2026Article
- Changing genetic profiles ofAntimicrobial agents and chemotherapy · 2026Article
- MMS Américas: a regional network for malaria molecular surveillance.Malaria journal · 2026Article
- Major features of parasite adaptation revealed by genomes of Plasmodium falciparum population samples archived for over 50 years.Communications biology · 2026Article
- No evidence of molecular markers of piperaquine resistance in southeastern Nigeria.Malaria journal · 2025Article
- Changes in susceptibility of Plasmodium falciparum to antimalarial drugs in Uganda over time: 2019-2024.Nature communications · 2025Article
- The plasmepsin-piperaquine paradox persists in Plasmodium falciparum.PLoS pathogens · 2025Article
- Evaluating the impact of the Malakit intervention on malaria transmission in the Guiana Shield: a mathematical modelling study.Lancet regional health. Americas · 2025Article
- A NovelmedRxiv : the preprint server for health sciences · 2025Article
- Plasmodium falciparum African PfCRT Mutant Isoforms Conducive to Piperaquine Resistance Are Infrequent and Impart a Major Fitness Cost.The Journal of infectious diseases · 2025Article
- Temporal Patterns of Haplotypic and Allelic Diversity Reflect the Changing Selection Landscape of the Malaria Parasite Plasmodium falciparum.Molecular biology and evolution · 2025Article
- [Malaria control in French Guiana: What are the challenges in this last endemic French territory in 2024?]Medecine tropicale et sante internationale · 2025Article
- Emerging trends and new developments in global research on artemisinin and its derivatives.Heliyon · 2025Article
- Low prevalence of copy number variation in pfmdr1 and pfpm2 in Plasmodium falciparum isolates from southern Angola.Malaria journal · 2025Article
- Targeting Malaria's Achilles' Heels: A Review of Plasmodium Life Cycle Vulnerabilities for Drug Discovery.Current topics in medicinal chemistry · 2025Review
- Dihydroartemisinin-Piperaquine Combination in the Treatment of UncomplicatedJournal of clinical medicine · 2024Review
- β-Carboline-3-carboxamide Antimalarials: Structure-Activity Relationship, ADME-Tox Studies, and Resistance Profiling.ACS infectious diseases · 2024Article
Corrections and comments
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Authors and funding
25 authors at 18 institutions in 12 countries.
Funding
Abstract
backgroundPlasmodium falciparum is an apicomplexan parasite responsible for lethal cases of malaria. According to WHO recommendations, P falciparum cases are treated with artemisinin-based combination therapy including dihydroartemisinin-piperaquine. However, the emergence of resistant parasites against dihydroartemisinin-piperaquine was reported in southeast Asia in 2008 and, a few years later, suspected in South America.
methodsTo characterise resistance emergence, a treatment efficacy study was performed on the reported patients infected with P falciparum and treated with dihydroartemisinin-piperaquine in French Guiana (n=6, 2016-18). Contemporary isolates collected in French Guiana were genotyped for P falciparum chloroquine resistance transporter (pfCRT; n=845) and pfpm2 and pfpm3 copy number (n=231), phenotyped using the in vitro piperaquine survival assay (n=86), and analysed through genomic studies (n=50). Additional samples from five Amazonian countries and one outside the region were genotyped (n=1440).
findingsIn field isolates, 40 (47%) of 86 (95% CI 35·9-57·1) were resistant to piperaquine in vitro; these phenotypes were more associated with pfCRT
interpretationThe high prevalence of piperaquine resistance markers in parasite populations of the Guianas, and the risk of associated therapeutic failures calls for caution on dihydroartemisinin-piperaquine use in the region. Furthermore, greater attention should be given to potential differences in genotype to phenotype mapping across genetically distinct parasite populations from different continents.
fundingPan American Health Organization and WHO, French Ministry for Research, European Commission, Santé publique France, Agence Nationale de la Recherche, Fundação de Amparo à Pesquisa do Estado do Amazonas, Ministry of Health of Brazil, Oswaldo Cruz Foundation, and National Institutes of Health. TRANSLATIONS: For the French and Portuguese translations of the abstract see Supplementary Materials section.
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