AI Article Synopsis
- Artemisinin-based combination therapy (ACT) is the leading treatment for uncomplicated malaria and essential for global malaria control, but resistance to this treatment has been observed in the Greater Mekong Subregion (GMS), particularly through slow parasite clearance and genetic mutations.
- A study genotyped 277 malaria samples from eight provinces in Thailand (2012-2016) to identify mutations associated with artemisinin resistance, revealing a geographical distribution of these mutations across the country.
- The prevalence of artemisinin resistance mutations has increased significantly over the past decade, especially along the Thai-Cambodia border, highlighting the need for intensified monitoring of resistance and treatment effectiveness in the region.
Article Abstract
Artemisinin-based combination therapy (ACT) is the most effective and widely used treatment for uncomplicated malaria and is a cornerstone for malaria control and prevention globally. Resistance to artemisinin derivatives has been confirmed in the Greater Mekong Subregion (GMS) and manifests as slow parasite clearance in patients and reduced ring stage susceptibility to artemisinins in survival assays. The gene mutations associated with artemisinin-resistant parasites are now widespread in the GMS. We genotyped 277 samples collected during an observational study from 2012 to 2016 from eight provinces in Thailand to identify mutations. The results were combined with previously reported genotyping results from Thailand to construct a map illustrating the evolution of mutations from 2007 to 2016 in that country. Different mutant alleles were found in strains with different geographical origins. The artemisinin resistance-conferring Y493H and R539T mutations were detected mainly in eastern Thailand (bordering Cambodia), while P574L was found only in western Thailand and R561H only in northwestern Thailand. The C580Y mutation was found across the entire country and was nearing fixation along the Thai-Cambodia border. Overall, the prevalence of artemisinin resistance mutations increased over the last 10 years across Thailand, especially along the Thai-Cambodia border. Molecular surveillance and therapeutic efficacy monitoring should be intensified in the region to further assess the extent and spread of artemisinin resistance.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914000 | PMC |
| http://dx.doi.org/10.1128/AAC.02141-17 | DOI Listing |
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