Spread of artemisinin-resistant Plasmodium falciparum in Myanmar: a cross-sectional survey of the K13 molecular marker.
Bottom Line: Artemisinin resistance extends across much of Myanmar.Appropriate therapeutic regimens should be tested urgently and implemented comprehensively if spread of artemisinin resistance to other regions is to be avoided.Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme and the Bill & Melinda Gates Foundation.
Affiliation: Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Defence Services Medical Research Centre, Naypyitaw, Myanmar.Show MeSH
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Mentions: Several mutations seemed to be concentrated in specific regions of Myanmar (figure 3). F446I was identified in 80 samples across six states or regions with several regions in Upper Myanmar showing prevalences in excess of 10%; 21 (47%) of 45 samples obtained in Homalin, Sagaing Region (25 km from the India border) had K13-propeller mutations (mostly the F446I mutation). The P574L mutation was also widely identified, being present in 41 samples across seven states or regions, whereas the A676D mutation was identified in three northern states or regions only (figure 3). The C580Y mutation, identified at high prevalence in western Cambodia,4 was confined to Kayin state, and was also present at high prevalence across the adjacent western part of Tak province in Thailand (figure 3). Notably, the M476I mutation, shown to develop after prolonged in-vitro artemisinin selection,4 was identified in 18 isolates.
Affiliation: Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Defence Services Medical Research Centre, Naypyitaw, Myanmar.