Genomic Tools Trace Multidrug-Resistant Malaria in Southeast Asia

Multidrug-resistant malaria spread rapidly in parts of southeast Asia under selection pressure of dihydroartemisinin-piperaquine combination treatment.

Resistance of Plasmodium falciparum to artemisinin and a key partner drug, piperaquine, has spread widely in southeast Asia since 2008. To better understand the origin and spread of resistant parasites, investigators conducted a genome sequence analysis of 1492 parasite samples collected from 11 locations in southeast Asia between 2007 and 2013.

They found >30 independent origins of artemisinin resistance, indicated by kelch13 gene mutations. A specific lineage (KEL1) came to predominate. Amplifications of plasmepsin 2-3 mark piperaquine resistance; all parasites resistant to dihydroartemisinin-piperaquine belonged to a single lineage, PLA1. The combination of KEL1 and PLA1 in parasites increased from 4% in 2007 to 63% in western Cambodia in…

Reviewing Author

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Genomic Tools Trace Multidrug-Resistant Malaria in Southeast Asia

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Reviewing Author