Identification of an artemisinin-resistant kelch13 R515K mutant parasite in Senegal.

The emergence of artemisinin partial resistance (ART-r) in malaria parasites has substantially compromised the efficacy of antimalarial treatments across southeast Asia (SE Asia). The spread of ART-r within the African continent could jeopardize past progress made in reducing worldwide malaria burden. A clinical index malaria case was identified in Kaolack, Senegal with persistent fever after complete artesunate-amodiaquine (ASAQ) treatment. Fifteen malaria-infected blood samples were collected by Institut Pasteur Dakar's Senegalese sentinel surveillance system, from different healthcare centers surrounding the index case. We have identified one clinical isolate carrying R515K mutation in the artemisinin resistance gene PfKelch13. CRISPR-Cas9 genome editing was carried out and transgenic Pf3D7Pfkelch13 was tested for standard Ring-stage Survival Assay ). Gene editing has confirmed that drove increased RSA value. In this article, we report the functional significance of PfKelch13 mutation in an African context.