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Peer reviewedOpen accessMalaria

Artemisinin - Resistant Plasmodium falciparum with High Survival Rates, Uganda, 2014–2016

Emerging Infectious Diseases·

Mie Ikeda, Megumi Kaneko, Shin-Ichiro Tachibana, Betty Balikagala, Miki Sakurai-Yatsushiro, Shouki Yatsushiro, Nobuyuki Takahashi, Masato Yamauchi, Makoto Sekihara, Muneaki Hashimoto, Osbert T. Katuro, Alex Olia, Paul S. Obwoya, Mary A. Auma, Denis A. Anywar, Emmanuel I. Odongo-Aginya, Joseph Okello-Onen, Makoto Hirai, Jun Ohashi, Nirianne M.Q. Palacpac, Masatoshi Kataoka, Takafumi Tsuboi, Eisaku Kimura, Toshihiro Horii, Toshihiro Mita

DOI
10.3201/eid2404.170141
PMID
29553316
PMCID
PMC5875287
OpenAlex
W2791105224
Study type
Journal article
Publisher
Centers for Disease Control and Prevention (CDC)
Article type
journal-article
Integrity
current

Why this research matters now

Because approximately 90% of malaria cases occur in Africa, the emergence of possibly artemisinin-resistant P. falciparum in Uganda represents a public health concern. The authors advocate large-scale surveillance to inform treatment outcomes and regional malaria control.

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Structured evidence summary

Research question

The study assesses the emergence of artemisinin-resistant Plasmodium falciparum in Uganda during 2014–2016 using an ex vivo ring-stage survival assay.

Study design

Four cross-sectional surveys using an ex vivo ring-stage survival assay to assess artemisinin sensitivity of P. falciparum isolates, with population genetics analysis.

Population and setting

Plasmodium falciparum isolates (n=194) collected from patients in Gulu, Uganda, during 2014–2016.

Main findings

Four of 194 isolates exhibited high ring-stage survival rates (>10%) considered a proxy for the artemisinin-resistant phenotype. A PfKelch13 mutation (A675V) was observed in only one of these four isolates. Population genetics analysis suggested African origin of the possibly resistant strains.

Public-health relevance

Because approximately 90% of malaria cases occur in Africa, the emergence of possibly artemisinin-resistant P. falciparum in Uganda represents a public health concern. The authors advocate large-scale surveillance to inform treatment outcomes and regional malaria control.

Important limitations

This summary is limited to the supplied single-article abstract and metadata and requires the original paper for decision-grade interpretation. The abstract does not explicitly state limitations of the study.

GIDS interpretation

The paper is indexed under the disease 'Malaria' and country 'Uganda' and would be discoverable through searches on artemisinin-resistant Plasmodium falciparum in Africa. It should not be interpreted as direct confirmation of a live surveillance signal without consulting the underlying surveillance data.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 6 auditable classifier relationships to diseases, places, topics, and study design.

about diseasehas pathogen typestudied instudied population settingstudies pathogenuses study design