Clonal spread ofPlasmodium falciparumcandidate artemisinin partial resistanceKelch13622I mutation and co-occurrence withpfhrp2/3deletions in Ethiopia

• DOI: 10.1101/2023.03.02.23286711
• Publication Date: 2023-03-08T07:35:18Z
• Authors: Abebe A. Fola; Sindew M. Feleke; Hussein Mohammed; Bokretsion G. Brhane; Christopher M. He...; Ashenafi Assefa; Rebecca M. Crudal; Emily Reichert; Jonathan J. Juliano; Jane Cunningham; Hassen Mamo; Hiwot Solomon; Geremew Tasew; Beyene Petros; Jonathan B Parr; Jeffrey A. Bailey
• Keywords: Piperaquine

Abstract The emergence and spread of drug- diagnostic-resistant Plasmodium falciparum are major impediments to malaria control elimination. We deep sequenced known drug resistance mutations other informative loci across the genome 609 samples collected during a study three regions Ethiopia. found that 8.0% (95% CI 7.0-9.0) cases were caused by P. carrying candidate artemisinin partial-resistance K13 622I mutation, which occurred less commonly in pfhrp2/3- deleted than normal non-deleted parasites ( p =0.03). Identity-by-descent analysis showed significantly more related wild-type (p<0.001), consistent with recent expansion spread. Pfhrp2/3- also highly related, evidence clonal transmissions at district level. Parasites both pfhrp2/3 deletion mutation observed some sites. These findings raise concern for future combined warrant close monitoring.