In the Horn of Africa, Malaria Parasites Can Evade Diagnosis and Resist Treatment

Partial resistance to artemisinin is mounting in Eritrea, possibly accompanied by deletions rendering parasites undetectable with rapid diagnostic malaria tests.

In East and Central Africa, Plasmodium falciparum with partial resistance to artemisinin is on the rise (NEJM JW Infect Dis Aug 30 2023 and N Engl J Med 2023 Aug 24; 389:722). With whole-genome sequencing, investigators in Eritrea analyzed data from drug-efficacy studies conducted in 2016, 2017, and 2019 to characterize clinical resistance (defined as day-3 parasite positivity after a supervised 3-day course of artesunate-amodiaquine or artemether-lumefantrine) in 852 patients with uncomplicated P. falciparum malaria.

Rates of day-3 positivity rose from 0.4% (2016) to 4.2% (2019), exceeding 10% at one site. Prevalence of parasites carrying a specific Pfkelch13 mutation (Pfkelch13 R622I, a marker of partial resistance to artemisinin) increase…

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

In the Horn of Africa, Malaria Parasites Can Evade Diagnosis and Resist Treatment

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Reviewing Author