1. Molecular markers of artemisinin resistance during falciparum malaria elimination in Eastern Myanmar.
- Author
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Delmas, Gilles, Watthanaworawit, Wanitda, McLean, Alistair, Arya, Ann, Reyes, Ann, Li, Xue, Miotto, Olivo, Soe, Kyaw, Ashley, Elizabeth, Dondorp, Arjen, White, Nicholas, Day, Nicholas, Anderson, Tim, Imwong, Mallika, Nosten, Francois, Smithuis, Frank, Thu, Aung, Phyo, Aung, Pateekhum, Chanapat, Rae, Jade, Landier, Jordi, and Parker, Daniel
- Subjects
P. falciparum ,Artemisinin resistance ,Kelch13 ,Malaria elimination ,Mass drug administration ,Artemisinins ,Myanmar ,Malaria ,Falciparum ,Antimalarials ,Drug Resistance ,Plasmodium falciparum ,Humans ,Cross-Sectional Studies ,Female ,Male ,Adolescent ,Adult ,Mass Drug Administration ,Young Adult ,Mutation ,Child ,Child ,Preschool ,Middle Aged ,Quinolines ,Disease Eradication ,Piperazines - Abstract
BACKGROUND: Artemisinin resistance in Plasmodium falciparum threatens global malaria elimination efforts. To contain and then eliminate artemisinin resistance in Eastern Myanmar a network of community-based malaria posts was instituted and targeted mass drug administration (MDA) with dihydroartemisinin-piperaquine (three rounds at monthly intervals) was conducted. The prevalence of artemisinin resistance during the elimination campaign (2013-2019) was characterized. METHODS: Throughout the six-year campaign Plasmodium falciparum positive blood samples from symptomatic patients and from cross-sectional surveys were genotyped for mutations in kelch-13-a molecular marker of artemisinin resistance. RESULT: The program resulted in near elimination of falciparum malaria. Of 5162 P. falciparum positive blood samples genotyped, 3281 (63.6%) had K13 mutations. The prevalence of K13 mutations was 73.9% in 2013 and 64.4% in 2019. Overall, there was a small but significant decline in the proportion of K13 mutants (p
- Published
- 2024