Surveillance of Artemisinin Resistance in Plasmodium falciparum in India Using the kelch13 Molecular Marker

Abstract

ABSTRACTMalaria treatment in Southeast Asia is threatened with the emergence of artemisinin-resistantPlasmodium falciparum. Genome association studies have strongly linked a locus onP. falciparumchromosome 13 to artemisinin resistance, and recently, mutations in the kelch13 propeller region (Pfk-13) were strongly linked to resistance. To date, this information has not been shown in Indian samples.Pfk-13mutations were assessed in samples from efficacy studies of artemisinin combination treatments in India. Samples were PCR amplified and sequenced from codon 427 to 727. Out of 384 samples, nonsynonymous mutations in the propeller region were found in four patients from the northeastern states, but their presence did not correlate with ACT treatment failures. This is the first report ofPfk-13point mutations from India. Further phenotyping and genotyping studies are required to assess the status of artemisinin resistance in this region.