ArticleBMC infectious diseases2025
Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Plasmodium falciparum antimalarial resistance in Angola: a systematic review.Malaria journal · 2026Pooled it
- Spatial and temporal description of antimalarial drug resistance markers in Ghana using targeted amplicon deep sequencing.Antimicrobial agents and chemotherapy · 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
- Global-scale population genetic analysis of Plasmodium falciparum identifies region-specific patterns of malaria parasite adaptation.Nature communications · 2026Article
- The MARC SE-Africa dashboard: Joining forces to counteract emerging antimalarial resistance in South and East Africa.PLOS digital health · 2026Article
- Spatiotemporal antimalarial drug resistance saturation and emerging artemisinin tolerance in western Kenya during a pilot multiple first-line treatment study.Scientific reports · 2026Article
- Persistent and CirculatingPathogens (Basel, Switzerland) · 2026Article
- Evolving patterns of antimalarial drug resistance markers in symptomatic infections in Kenya, 2013-2022.Parasites & vectors · 2026Article
- Article
- A scoping review of antimalarial drug resistance markers in Kenya (1987-2022): toward a National Surveillance Framework and Data Repository.Malaria journal · 2025Article
- Serial cross-sectional school surveys identifies C469Y, P553L, R561H and A675V kelch 13 mutations associated with artemisinin resistance in Western Kenya.Scientific reports · 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
- Regional variation in sulfadoxine-pyrimethamine resistance genotypes and haplotypes of Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase genes in Western Kenya.Malaria journal · 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
- Prevalence of Plasmodium falciparum parasites harbouring chloroquine-resistant but not artemisinin-resistant alleles in Busia County, Western Kenya.Malaria journal · 2025Article
- A NovelmedRxiv : the preprint server for health sciences · 2025Article
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Abstract
backgroundTo understand the emergence and spread of drug-resistant parasites in malaria-endemic areas, accurate assessment and monitoring of antimalarial drug resistance markers is critical. Recent advances in next-generation sequencing (NGS) technologies have enabled the tracking of drug-resistant malaria parasites.
methodsIn this study, we used Targeted Amplicon Deep Sequencing (TADS) to characterise the genetic diversity of the Pfk13, Pfdhfr, Pfdhps, and Pfmdr1 genes among primary school-going children in 15 counties in Kenya (Bungoma, Busia, Homa Bay, Migori, Kakamega, Kilifi, Kirinyaga, Kisii, Kisumu, Kwale, Siaya, Tana River, Turkana, Vihiga and West Pokot). A total of 920 dried blood spot (DBS) samples collected from 121 selected primary schools within the country were used to extract genomic DNA. A nested polymerase chain reaction (PCR) was used to generate amplicons that were sequenced to determine the prevalence of known and novel polymorphisms.
resultsPfk13 mutations associated with artemisinin resistance were present as mixed genotype infections for the C469Y mutation in 23 samples (4%), the A675V mutation in 2 samples (1.7%), and the P553L mutation in 7 samples (1.2%). The A578S mutation, was also identified in mixed infections, appearing in 15.2% of the 87 samples analysed. The Pfdhfr 51I and 108 N pyrimethamine-resistance mutations were at fixation (100% frequency), and the Pfmdr1 Y184F mutation, which is linked to reduced susceptibility to several antimalarial drugs, especially those used in combination therapies for malaria treatment, was detected in 97.5% of the samples as mixed-genotype infections.
conclusionThe genomic surveillance of asymptomatic school children in Kenya provides an early warning signal of at least 1 of the 3 validated artemisinin resistance mutations circulating in all regions in Western Kenya sampled except Homa Bay and Kisii Counties. These signals in asymptomatic and mixed infections would have been missed without deep sequencing.
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