<i>Plasmodium falciparum kelch</i><i>13</i> Mutations, 9 Countries in Africa, 2014–2018
Sarah E. Schmedes, Dhruviben Patel, Simran Dhal, Julia Kelley, Samaly S. Svigel, Pedro Rafael Dimbu, Adicatou-Laï Adeothy, Gauthier Mesia Kahunu, Papy Mandoko Nkoli, Abdoul Habib Béavogui, Simon Kariuki, Don P. Mathanga, Ousmane Koita, Deus S. Ishengoma, Ally Mohamad, Moonga Hawela, Leah F. Moriarty, Aaron M. Samuels, Julie Gutman, Mateusz M. Pluciński, Venkatachalam Udhayakumar, Zhiyong Zhou, Naomi W. Lucchi, Meera Venkatesan, Eric S. Halsey, Eldin Talundzic
Abstract
The spread of drug resistance to antimalarial treatments poses a serious public health risk globally. To combat this risk, molecular surveillance of drug resistance is imperative. We report the prevalence of mutations in the Plasmodium falciparum kelch 13 propeller domain associated with partial artemisinin resistance, which we determined by using Sanger sequencing samples from patients enrolled in therapeutic efficacy studies from 9 sub-Saharan countries during 2014-2018. Of the 2,865 samples successfully sequenced before treatment (day of enrollment) and on the day of treatment failure, 29 (1.0%) samples contained 11 unique nonsynonymous mutations and 83 (2.9%) samples contained 27 unique synonymous mutations. Two samples from Kenya contained the S522C mutation, which has been associated with delayed parasite clearance; however, no samples contained validated or candidate artemisinin-resistance mutations.