Current Status And Genetic Analysis of Artemisinin Resistance in Malaria

DOI: 10.6525/TEB.202012_36(24).0001

Shu-Ying Li1*, Aaron Neal2, Zi-Qi Lin1, Sin-Rong Lu1, Hwa-Jen Teng1, Jen-Jen Hsu1, Shih-Fen Hsu1

2020 Vol.36 NO.24

Correspondence Author: Shu-Ying Li1*

  • 1Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan  
  • 2Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA


        Malaria is still an important public health issue to date. Artemisinin-based combination therapies (ACTs) are highly effective and have been recommended by the World Health Organization as the first-line treatment for Plasmodium falciparum infection. 
        Since 2008, ACT resistance has been reported in the Greater Mekong Subregion. The efficacy of ACTs has gradually decreased with its widespread use. Now the world is deeply concerned with the spreading of artemisinin resistance and ACT multidrug resistance. Mutations in the propeller domain of the P. falciparum kelch13 (pfK13) gene are associated with artemisinin resistance. In order to assess the artemisinin resistance of imported malaria in Taiwan, we sequenced pfK13 gene of four falciparum malaria cases imported from Kenya, Solomon Islands and Uganda in 2018 and no mutations were found in pfK13 gene.
        To better cope with imported malaria cases, measures such as clinical observations, travel history inquiry, laboratory diagnosis and follow-up should be reinforced. In addition, for patients from Greater Mekong Subregion with parasitemia after therapy regimen, the possibility of resistance should be evaluated, and malaria drug resistance genes, such as pfKelch‐13 gene, should be sequenced to assess the resistance of artemisinin for timely adjustment of treatment strategies. These efforts assist in more rational use of antimalarial drugs, delay the development of drug resistance and maintain the effectiveness of artemisinin.