TY - JOUR AU - Ikeda, Mie AU - Kaneko, Megumi AU - Tachibana, Shin-Ichiro AU - Balikagala, Betty AU - Sakurai-Yatsushiro, Miki AU - Yatsushiro, Shouki AU - Takahashi, Nobuyuki AU - Yamauchi, Masato AU - Sekihara, Makoto AU - Hashimoto, Muneaki AU - Katuro, Osbert AU - Olia, Alex AU - Obwoya, Paul AU - Auma, Mary AU - Anywar, Denis AU - Odongo-Aginya, Emmanuel AU - Okello-Onen, Joseph AU - Hirai, Makoto AU - Ohashi, Jun AU - Palacpac, Nirianne M.Q. AU - Kataoka, Masatoshi AU - Tsuboi, Takafumi AU - Kimura, Eisaku AU - Horii, Toshihiro AU - Mita, Toshihiro T1 - Artemisinin-Resistant Plasmodium falciparum with High Survival Rates, Uganda, 2014–2016 T2 - Emerging Infectious Disease journal PY - 2018 VL - 24 IS - 4 SP - 718 SN - 1080-6059 AB - Because ≈90% of malaria cases occur in Africa, emergence of artemisinin-resistant Plasmodium falciparum in Africa poses a serious public health threat. To assess emergence of artemisinin-resistant parasites in Uganda during 2014–2016, we used the recently developed ex vivo ring-stage survival assay, which estimates ring-stage–specific P. falciparum susceptibility to artemisinin. We conducted 4 cross-sectional surveys to assess artemisinin sensitivity in Gulu, Uganda. Among 194 isolates, survival rates (ratio of viable drug-exposed parasites to drug-nonexposed controls) were high (>10%) for 4 isolates. Similar rates have been closely associated with delayed parasite clearance after drug treatment and are considered to be a proxy for the artemisinin-resistant phenotype. Of these, the PfKelch13 mutation was observed in only 1 isolate, A675V. Population genetics analysis suggested that these possibly artemisinin-resistant isolates originated in Africa. Large-scale surveillance of possibly artemisinin-resistant parasites in Africa would provide useful information about treatment outcomes and help regional malaria control. KW - Artemisinin KW - drug resistance KW - Plasmodium falciparum KW - Uganda KW - parasites KW - malaria KW - antimicrobial resistance DO - 10.3201/eid2404.170141 UR - https://wwwnc.cdc.gov/eid/article/24/4/17-0141_article ER - End of Reference