Evidence map›Paper›PMID 38552654›Full record

ReviewThe Lancet. Infectious diseases2024

The emergence of artemisinin partial resistance in Africa: how do we respond?

Philip J Rosenthal, Victor Asua, Jeffrey A Bailey, Melissa D Conrad, Deus S Ishengoma, Moses R Kamya, Charlotte Rasmussen, Fitsum G Tadesse, Aline Uwimana, David A Fidock

Open access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The Lancet. Infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
113citing papers in PubMed, 10 pooled it
76.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

113 citing papers in PubMed, 10 syntheses or guidelines pooled it, 140 citations in OpenAlex.

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  5. The Global Landscape ofPathogens (Basel, Switzerland) · 2026
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  20. Protection againstMicrobiology spectrum · 2026
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53 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 9 institutions in 9 countries.

Philip J RosenthalDepartment of Medicine, University of California, San Francisco, CA, USA. Electronic address: philip.rosenthal@ucsf.edu.
Victor AsuaInfectious Diseases Research Collaboration, Kampala, Uganda; University of Tübingen, Tübingen, Germany.
Jeffrey A BaileyCenter for Computational Molecular Biology, Brown University, Providence, RI, USA; Departments of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA.
Melissa D ConradDepartment of Medicine, University of California, San Francisco, CA, USA.
Deus S IshengomaNational Institute for Medical Research, Dar es Salaam, Tanzania; Department of Biochemistry, Kampala International University in Tanzania, Dar es Salaam, Tanzania; School of Public Health, Harvard University, Boston, MA, USA.
Moses R KamyaInfectious Diseases Research Collaboration, Kampala, Uganda; Department of Medicine, Makerere University, Kampala, Uganda.
Charlotte RasmussenWHO, Geneva, Switzerland.
Fitsum G TadesseArmauer Hansen Research Institute, Addis Ababa, Ethiopia; London School of Hygiene and Tropical Medicine, London, UK.
Aline UwimanaRwanda Biomedical Center, Kigali, Rwanda; Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
David A FidockDepartment of Microbiology and Immunology and Center for Malaria Therapeutics and Antimicrobial Resistance, Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
University of California, San Francisco · USBrown University · USColumbia University Irving Medical Center · USInfectious Diseases Research Collaboration · UGKampala International University · TZLondon School of Hygiene & Tropical Medicine · GBMakerere University · UGUCLouvain · BEWorld Health Organization · CH

Funding

Defining P. falciparum resistance to artemisinin-based combination therapiesR01AI109023 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI FIDOCK, DAVID A · 2014 to 2025
$4.4M
Surveillance to track and characterize antimalarial resistance trends in Ugandan Plasmodium falciparum parasites (STARTUP)R01AI173557 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Melissa D Conrad · 2023 to 2026
$2.9M
Defining the complex genetic basis of Plasmodium falciparum resistance to artemisinin and quinine and identifying resistance-refractory therapeuticsR01AI185559 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI David A Fidock · 2024 to 2026
$1.9M
NIAID NIH HHS R01 AI109023NIAID NIH HHS R01 AI185559World Health Organization 001
6 · The paper itself

Abstract

Malaria remains one of the most important infectious diseases in the world, with the greatest burden in sub-Saharan Africa, primarily from Plasmodium falciparum infection. The treatment and control of malaria is challenged by resistance to most available drugs, but partial resistance to artemisinins (ART-R), the most important class for the treatment of malaria, was until recently confined to southeast Asia. This situation has changed, with the emergence of ART-R in multiple countries in eastern Africa. ART-R is mediated primarily by single point mutations in the P falciparum kelch13 protein, with several mutations present in African parasites that are now validated resistance mediators based on clinical and laboratory criteria. Major priorities at present are the expansion of genomic surveillance for ART-R mutations across the continent, more frequent testing of the efficacies of artemisinin-based regimens against uncomplicated and severe malaria in trials, more regular assessment of ex-vivo antimalarial drug susceptibilities, consideration of changes in treatment policy to deter the spread of ART-R, and accelerated development of new antimalarial regimens to overcome the impacts of ART-R. The emergence of ART-R in Africa is an urgent concern, and it is essential that we increase efforts to characterise its spread and mitigate its impact.

Indexed as

AntimalarialsArtemisininsDrug ResistanceMalaria, FalciparumPlasmodium falciparumAfricaHumansProtozoan ProteinsAntimalarialsartemisininArtemisininsProtozoan Proteins

Identifiers

PMID38552654
PMCPMC12954456
OpenAlexW4393183623

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.