| Autor: |
Molina-de la Fuente I; Department of Biomedicine and Biotechnology, School of Pharmacy, University of Alcalá, Alcalá de Henares, Madrid, Spain.; Malaria and Neglected Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain.; CIBERINFECT - CIBER Infectious Diseases, Madrid, Spain., Sagrado Benito MJ; Médecins Sans Frontières, Barcelona, Spain., Ousley J; Médecins Sans Frontières, New York, New York., Gisbert FB; Médecins Sans Frontières, Barcelona, Spain., García L; Malaria and Neglected Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain.; CIBERINFECT - CIBER Infectious Diseases, Madrid, Spain., González V; Malaria and Neglected Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain.; CIBERINFECT - CIBER Infectious Diseases, Madrid, Spain., Benito A; Malaria and Neglected Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain.; CIBERINFECT - CIBER Infectious Diseases, Madrid, Spain., Chol BT; Médecins Sans Frontières, Juba, South Sudan., Julla A; Ministry of Health, Juba, South Sudan., Bakri A; Médecins Sans Frontières, Nairobi, Kenya., Nanclares C; Médecins Sans Frontières, Barcelona, Spain., Berzosa P; Malaria and Neglected Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain.; CIBERINFECT - CIBER Infectious Diseases, Madrid, Spain. |
| Abstrakt: |
Artemisinin-combined treatments are the recommended first-line treatment of Plasmodium falciparum malaria, but they are being threatened by emerging artemisinin resistance. Mutations in pfk13 are the principal molecular marker for artemisinin resistance. This study characterizes the presence of mutations in pfk13 in P. falciparum in Western Equatoria State, South Sudan. We analyzed 468 samples from patients with symptomatic malaria and found 15 mutations (8 nonsynonymous and 7 synonymous). Each mutation appeared only once, and none were validated or candidate markers of artemisinin resistance. However, some mutations were in the same or following position of validated and candidate resistance markers, suggesting instability of the gene that could lead to resistance. The R561L nonsynonymous mutation was found in the same position as the R561H validated mutation. Moreover, the A578S mutation, which is widespread in Africa, was also reported in this study. We found a high diversity of other pfk13 mutations in low frequency. Therefore, routine molecular surveillance of resistance markers is highly recommended to promptly detect the emergence of resistance-related mutations and to limit their spread. |
