Evidence map›Paper›PMID 40748991›Full record

ArticlePloS one2025

CYP2B6*6 single nucleotide polymorphism among patients with uncomplicated malaria in Adjumani district, Uganda: Implications on efficacy of artemether-lumefantrine.

Martin Kamilo Angwe, Norah Mwebaza, Sam Lubwama Nsobya, Ronald Kiguba, Patrick Vudriko, Saviour Dralabu, Denis Omali, Maria Agnes Tumwebaze, Moses Ocan

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

  • Update of
    2025
5 · Who and what money

Authors and funding

9 authors.

Martin Kamilo AngweDepartment of Pharmacology and Therapeutics, College of Health Science, Makerere University, Kampala, Uganda.ORCID 0000-0002-1211-7762
Norah MwebazaDepartment of Pharmacology and Therapeutics, College of Health Science, Makerere University, Kampala, Uganda.
Sam Lubwama NsobyaInfectious Diseases Research Collaboration, Makerere University, Kampala, Uganda.
Ronald KigubaDepartment of Pharmacology and Therapeutics, College of Health Science, Makerere University, Kampala, Uganda.
Patrick VudrikoResearch Centre for Tropical Diseases and Vector Control, School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.
Saviour DralabuResearch Centre for Tropical Diseases and Vector Control, School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.
Denis OmaliDepartment of Pharmacology and Therapeutics, College of Health Science, Makerere University, Kampala, Uganda.ORCID 0000-0001-6557-8928
Maria Agnes TumwebazeResearch Centre for Tropical Diseases and Vector Control, School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.
Moses OcanDepartment of Pharmacology and Therapeutics, College of Health Science, Makerere University, Kampala, Uganda.ORCID 0000-0002-8852-820X

Funding

Health Professions Education and training for strengthening the health system and services in UgandaR25TW011213 · FIC · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI KIGULI, SARAH · 2018 to 2022
$3.4M
FIC NIH HHS R25 TW011213
6 · The paper itself

Abstract

CYP2B6, one of the most polymorphic enzymes, plays a major role in the metabolism of artemisinin and its derivatives. Variation in the frequency of the most common, yet functionally deficient CYP2B6*6 allele may impact artemisinin exposure, potentially contributing to differences in treatment outcomes. This study assessed the prevalence of the CYP2B6*6 genotype among patients with uncomplicated malaria treated with artemether-lumefantrine at Adjumani District Hospital in the West Nile region, Uganda. A total of 100 randomly selected patients with microscopically confirmed uncomplicated P. falciparum malaria receiving artemether-lumefantrine (AL) were included in the study. Blood samples, 2-3 mL each, were collected using EDTA tubes on days 0 and 3 after AL administration. DNA was extracted using Qiagen DNA Mini kit. Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) was used to determine the CYP2B6*6 genotype of the participants. P. falciparum positivity was determined by microscopy and qPCR. For qPCR, parasite clearance was determined using comparative CT value. Data analysis was done using STATA ver 17.0 at a 95% significance level. Among the malaria patients genotyped, 65% were female, and 35% were male, with a mean age of 17 ± 10 years. The CYP2B6*6 variant allele frequency was 0.37, and the genotype frequency was 43% GG, 17% TT and 40% GT. P. falciparum day 3 microscopy positivity was 14% (6/43) among the GG, 37.5% (15/40) among the GT, and 17.64% (3/17) among the TT patients. PCR positivity rates were 58.1% (25/43) in the GG, 72.5% (29/40) in the GT, and 52.9% (9/17) in the TT patients. Heterozygous individuals (GT) had slow parasite clearance by a 10-fold difference compared to the homozygous (GG, TT) individuals (U = 323.0; Z = -2.3442; p = 0.019). Malaria patients in Adjumani district had a high frequency of the CYP2B6*6 variant allele. Interindividual variability in P. falciparum clearance exists, with heterozygous patients demonstrating slow artemether-lumefantrine P. falciparum parasite clearance. There is a need to consider incorporating host genomic factors, such as metabolising enzyme genotype into routine Therapeutic Efficacy Studies (TES).

Indexed as

AntimalarialsArtemether, Lumefantrine Drug CombinationCytochrome P-450 CYP2B6Malaria, FalciparumPolymorphism, Single NucleotideAdolescentAdultAllelesArtemisininsChildFemaleGene FrequencyGenotypeHumansMalePlasmodium falciparumAntimalarialsArtemether, Lumefantrine Drug CombinationArtemisininsCYP2B6 protein, humanCytochrome P-450 CYP2B6

Identifiers

PMID40748991
PMCPMC12316228

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Registered trials

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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.