ArticleMalaria journal2024
Emerging threat of artemisinin partial resistance markers (pfk13 mutations) in Plasmodium falciparum parasite populations in multiple geographical locations in high transmission regions of Uganda.
Article in Malaria journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Asymptomatic malaria: a hidden reservoir for the transmission and circulation of artemisinin partial-resistantEmerging microbes & infections · 2026Article
- Genomic surveillance reveals co-occurrence of Plasmodium falciparum drug resistance variants across diverse transmission settings in Ethiopia.Nature microbiology · 2026Article
- Slowing the spread of treatment failure to artemisinin-based combination therapies in Uganda.Nature communications · 2026Article
- Absence of false negative RDT results due to pfhrp2 deletion among symptomatic malaria infections in Kenya: findings from the 2022 Kenya national longitudinal surveillance of pfhrp2/3 deletions.Malaria journal · 2026Article
- The MARC SE-Africa dashboard: Joining forces to counteract emerging antimalarial resistance in South and East Africa.PLOS digital health · 2026Article
- Molecular Surveillance of Malaria in Nigeria Reveals a Low Frequency of Antimalarial Resistance Markers and Clonal Expansion of Chloroquine-Sensitive Infections.Open forum infectious diseases · 2026Article
- Utility of TaqMan Array Cards for detection of acute febrile illness etiologies in patients suspected of viral hemorrhagic fever infections.BMC infectious diseases · 2025Article
- Multiplex long-amplicon sequencing for comprehensive molecular surveillance of Plasmodium falciparum resistance to artemisinin and partner drugs in artemisinin-based combination therapies (ACTs).Parasites & vectors · 2025Article
- Review
- Self-medication for malaria and associated factors in Kakumiro District, Uganda, August 2023: implications for malaria management and mortality prevention.Malaria journal · 2025Article
- Emerging Molecular Mechanisms in Malaria Pathogenesis and Novel Therapeutic Approaches: A Focus onBiomolecules · 2025Review
- Comprehensive analysis of molecular markers linked to antimalarial drug resistance in Plasmodium falciparum in Northern, Northeastern and Eastern Uganda.Malaria journal · 2025Article
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Abstract
backgroundArtemisinin-based combination therapy (ACT) is currently recommended for treatment of uncomplicated malaria. However, the emergence and spread of partial artemisinin resistance threatens their effectiveness for malaria treatment in sub-Saharan Africa where the burden of malaria is highest. Early detection and reporting of validated molecular markers (pfk13 mutations) in Plasmodium falciparum is useful for tracking the emergence and spread of partial artemisinin resistance to inform containment efforts.
methodsGenomic surveillance was conducted at 50 surveillance sites across four regions of Uganda in Karamoja, Lango, Acholi and West Nile from June 2021 to August 2023. Symptomatic malaria suspected patients were recruited and screened for presence of parasites. In addition, dried blood spots (DBS) were collected for parasite genomic analysis with PCR and sequencing. Out of 563 available dried blood spots (DBS), a random subset of 240 P. falciparum mono-infections, confirmed by a multiplex PCR were selected and used for detecting the pfk13 mutations by Sanger sequencing using Big Dye Terminator method. Regional variations in the proportions of pfk13 mutations were assessed using the chi square or Fisher's exact tests while Kruskal-Wallis test was used to compare absolute parasite DNA levels between wild type and mutant parasites.
resultsOverall, 238/240 samples (99.2%) contained sufficient DNA and were successfully sequenced. Three mutations were identified within the sequenced samples; pfk13 C469Y in 32/238 (13.5%) samples, pfk13 A675V in 14/238 (5.9%) and pfk13 S522C in (1/238 (0.42%) samples across the four surveyed regions. The prevalence of pfk13 C469Y mutation was significantly higher in Karamoja region (23.3%) compared to other regions, P = 0.007. The majority of parasite isolates circulating in West Nile are of wild type (98.3), P = 0.002. Relative parasite DNA quantity did not differ in samples carrying the wild type, C469Y and A675V alleles (Kruskal-Wallis test, P = 0.6373).
conclusionDetection of validated molecular markers of artemisinin partial resistance in multiple geographical locations in this setting provides additional evidence of emerging threat of artemisinin partial resistance in Uganda. In view of these findings, periodic genomic surveillance is recommended to detect and monitor levels of pfk13 mutations in other regions in parallel with TES to assess potential implication on delayed parasite clearance and associated treatment failure in this setting. Future studies should consider identification of potential drivers of artemisinin partial resistance in the different malaria transmission settings in Uganda.
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