ArticleThe Journal of infectious diseases2025
High Frequency of Artemisinin Partial Resistance Mutations in the Great Lakes Region Revealed Through Rapid Pooled Deep Sequencing.
Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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33 citing papers in PubMed.
- Changes in molecular markers of Plasmodium falciparum drug resistance between 2017 and 2024 in Southern Benin.International journal for parasitology. Drugs and drug resistance · 2026Article
- Emergence and spread of Plasmodium falciparum PX1 polymorphisms associated with decreased susceptibility to antimalarials in Uganda.Nature medicine · 2026Article
- Ex vivo susceptibility to dihydroartemisinin in Plasmodium falciparum patient isolates from Eastern Rwanda, 2025.Malaria journal · 2026Article
- Prevalence of molecular markers related to artemisinin partial resistance and ACT partner drug resistance in the Plasmodium falciparum population in Kongo Central, DRC.Malaria journal · 2026Article
- Cross-border molecular epidemiology of Plasmodium falciparum drug susceptibility: insights from the Uganda-Democratic Republic of the Congo border.Malaria journal · 2026Article
- The MARC SE-Africa dashboard: Joining forces to counteract emerging antimalarial resistance in South and East Africa.PLOS digital health · 2026Article
- National genomic profiling of Plasmodium falciparum antimalarial resistance in Zambian children participating in the 2018 malaria indicator survey.Scientific reports · 2026Article
- Public Health Perspectives on IntegratingTropical medicine and infectious disease · 2026Article
- Molecular surveillance of Falciparum malaria in Rwanda: Shifts in parasite prevalence and risk factors between the 2014-15 and 2019-20 Rwanda Demographics and Health Surveys.medRxiv : the preprint server for health sciences · 2026Article
- Artemisinin Partial Resistance Mutations in Zanzibar and Tanzania Suggest Regional Spread and African Origins, 2023.The Journal of infectious diseases · 2026Article
- Evolving patterns of antimalarial drug resistance markers in symptomatic infections in Kenya, 2013-2022.Parasites & vectors · 2026Article
- Temporal trends in artemisinin partial resistance and other antimalarial drug mutations inFrontiers in genetics · 2026Article
- High prevalence and emerging positive association of kelch13 R622I and HRP2-based RDT negativity in Plasmodium falciparum in northern Ethiopia.PLoS pathogens · 2025Article
- Temporal Trends in Artemisinin Partial Resistance and Other Antimalarial Drug Mutations inmedRxiv : the preprint server for health sciences · 2025Article
- Emergence and Rising Prevalence of Artemisinin Partial Resistance Marker Kelch13 P441L in a Low Malaria Transmission Setting in Southern Zambia.The Journal of infectious diseases · 2025Article
- Strategies for mitigating emerging artemisinin-based antimalarial drug resistance in Rwanda: a promising approach for managing therapies in malaria-endemic countries.BMJ global health · 2025Review
- Epidemiology of ovale, vivax and falciparum malaria in the highlands of Cameroon: An integrated community survey of human infection and vector abundance.PLoS neglected tropical diseases · 2025Article
- Mapping Plasmodium falciparum mutations in Africa: A critical review of emerging drug resistance and implications for malaria control.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Review
- Rising prevalence of Plasmodium falciparum Artemisinin partial resistance mutations in Ethiopia.Communications medicine · 2025Article
- Artemisinin and partner drug resistance markers in Plasmodium falciparum from Tanzanian paediatric malaria patients, 2016-2022.Malaria journal · 2025Article
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Abstract
backgroundIn Africa, the first Plasmodium falciparum artemisinin partial resistance mutation was Kelch13 (K13) 561H, detected and validated at appreciable frequency in Rwanda in 2014. Surveillance to better define the extent of the emergence in Rwanda and neighboring countries is critical.
methodsWe used novel liquid blood drop preservation with pooled sequencing to provide cost-effective rapid assessment of resistance mutation frequencies at multiple collection sites across Rwanda and neighboring regions in Uganda, Tanzania, and the Democratic Republic of the Congo. Malaria-positive samples (N = 5465) from 39 health facilities collected between May 2022 and March 2023 were sequenced in 199 pools.
resultsIn Rwanda, K13 561H and 675V were detected in 90% and 65% of sites, with an average frequency of 19.0% (range, 0%-54.5%) and 5.0% (0%-35.5%), respectively. In Tanzania, 561H had high frequency in multiple sites. 561H appeared at 1.6% in Uganda. 561H was absent from the Democratic Republic of the Congo, although 675V was seen at low frequency. Concerningly, candidate mutations were observed: 441L, 449A, and 469F co-occurred with validated mutations, suggesting that they are arising under the same pressures. Other markers for decreased susceptibility to artemether-lumefantrine are common: P falciparum multidrug resistance protein 1 N86 at 98.0% (range, 63.3%-100%) and 184F at 47.0% (0%-94.3%) and P falciparum chloroquine resistance transporter 76T at 14.7% (0%-58.6%). Additionally, sulfadoxine-pyrimethamine-associated mutations show high frequencies.
conclusionsK13 mutations are rapidly expanding in the region, further endangering control efforts with the potential of engendering partner drug resistance.
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