학술논문
Molecular markers of artemisinin resistance during falciparum malaria elimination in Eastern Myanmar.
Document Type
article
Author
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; Parker, Daniel
Source
Malaria Journal. 23(1)
Subject
Language
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