Publication: Plasmodium falciparum Kelch 13 mutations and treatment response in patients in Hpa-Pun District, Northern Kayin State, Myanmar.
Issued Date
2017
Resource Type
Language
eng
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Malaria Journal. Vol.16, No.1 (2017). 480
Suggested Citation
Bonnington, Craig A., Aung Pyae Phyo, Ashley, Elizabeth A., Mallika Imwong, Kanlaya Sriprawat, Parker, Daniel M., Proux, Stephane, White, Nicholas J., Nosten, Francois Plasmodium falciparum Kelch 13 mutations and treatment response in patients in Hpa-Pun District, Northern Kayin State, Myanmar.. Malaria Journal. Vol.16, No.1 (2017). 480. doi:10.1186/s12936-017-2128-x. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/43778
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Plasmodium falciparum Kelch 13 mutations and treatment response in patients in Hpa-Pun District, Northern Kayin State, Myanmar.
Abstract
Background: Artemisinin resistance, linked to polymorphisms in the Kelch gene on chromosome 13 of Plasmodium
falciparum (k13), has outpaced containment eforts in South East Asia. For national malaria control programmes in the
region, it is important to establish a surveillance system which includes monitoring for k13 polymorphisms associated
with the clinical phenotype.
Methods: Between February and December 2013, parasite clearance was assessed in 35 patients with uncomplicated P. falciparum treated with artesunate monotherapy followed by 3-day ACT in an isolated area on the Myanmar–
Thai border with relatively low artemisinin drug pressure. Molecular testing for k13 mutations was performed on dry
blood spots collected on admission.
Results: The proportion of k13 mutations in these patients was 41.7%, and only 5 alleles were detected: C580Y, I205T,
M476I, R561H, and F446I. Of these, F446I was the most common, and was associated with a longer parasite clearance
half-life (median) 4.1 (min–max 2.3–6.7) hours compared to 2.5 (min–max 1.6–8.7) in wildtype (p = 0·01). The prevalence of k13 mutant parasites was much lower than the proportion of k13 mutants detected 200 km south in a much
less remote setting where the prevalence of k13 mutants was 84% with 15 distinct alleles in 2013 of which C580Y
predominated.
Conclusions: This study provides evidence of artemisinin resistance in a remote part of eastern Myanmar. The prevalence of k13 mutations as well as allele diversity varies considerably across short distances, presumably because of
historical patterns of artemisinin use and population movements.