Kelch13 mutations in Plasmodium falciparum and risk of spreading in Amazon basin countries.

Background: The first potential focus for artemisinin resistance in South America was recently confirmed with the presence of the C580Y mutation in the Plasmodium falciparum kelch 13 gene (pfk13) in Guyana.

Objectives: This study aimed to strengthen pfk13 monitoring in the Amazon basin countries, to compile the available data and to evaluate the risk of spreading of mutations.

Methods: Sanger sequencing was done on 862 samples collected between 1998 and 2019, and a global map of pfk13 genotypes available for this region was constructed.

Local emergence in Amazonia of C580Y mutants associated with artemisinin resistance.

Antimalarial drug resistance has historically arisen through convergent mutations in parasite populations in Southeast Asia and South America. For the past decade in Southeast Asia, artemisinins, the core component of first-line antimalarial therapies, have experienced delayed parasite clearance associated with several mutations, primarily C580Y. We report that mutant has emerged independently in Guyana, with genome analysis indicating an evolutionary origin distinct from Southeast Asia.