Artemisinin partial resistance at a crossroads: evidence for continental variation in Plasmodium falciparum clearance phenotypes
The Lancet Infectious Diseases·
- DOI
- 10.1016/s1473-3099(26)00132-5
- PMID
- 42107390
- PMCID
- —
- OpenAlex
- W7160505182
- Study type
- Journal article
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Applying southeast Asia-derived clearance thresholds in Africa may obscure early signals of artemisinin partial resistance and delay policy responses, supporting the need for region-specific surveillance criteria.
Structured evidence summary
Research question
The review examines whether parasite clearance half-life thresholds developed in southeast Asia appropriately capture artemisinin partial resistance phenotypes in African settings.
Study design
A systematic review covering 96 studies across southeast Asia and Africa, of which 35 contributed genotype-linked parasite clearance half-life or ring-stage survival assay (RSA) data, or both.
Population and setting
Plasmodium falciparum infections studied in southeast Asia and Africa (including east Africa and the Horn of Africa), evaluated through genotype-linked clearance and survival phenotyping.
Main findings
In southeast Asia, parasites carrying canonical kelch13 mutations showed prolonged clearance half-lives alongside concordance with RSA survival. In east Africa and the Horn of Africa, independently emergent kelch13 mutations generally exhibited faster clearance kinetics despite elevated RSA survival rates, suggesting continental differences in resistance phenotypes.
Public-health relevance
Applying southeast Asia-derived clearance thresholds in Africa may obscure early signals of artemisinin partial resistance and delay policy responses, supporting the need for region-specific surveillance criteria.
Important limitations
This summary is limited to the supplied single-article abstract and metadata and requires review of the original paper for decision-grade interpretation; explicit study limitations were not provided in the supplied evidence.
GIDS interpretation
The paper is catalogued under malaria surveillance, treatment, and health policy topics, making it discoverable in genomic surveillance contexts; the summary does not connect the work to any live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 9 auditable classifier relationships to diseases, places, topics, and study design.