Volume 31, Number 6—June 2025
Dispatch
High Prevalence of Artemisinin-Resistant Plasmodium falciparum, Southeastern Sudan
Table 1
Frequency of the Pfkelch13, Pfcrt, Pfmdr-1, dhfr, and dhps genotypes in blood samples collected in patients with Plasmodium falciparum malaria before artemisinin-based combination therapy from Al Jazirah and Al Qadarif, Sudan, 2017*
| Gene | Codon | Amino acid | No. (%) samples |
p value | ||
|---|---|---|---|---|---|---|
| Al Jazirah | Al Qadarif | Total | ||||
| No. samples |
NA |
NA |
170 |
87 |
257 |
NA |
| Pfkelch13† |
Wilms tumor | NA | 123 (72.4) | 69 (79.3) | 192 (74.7) | 0.01 |
| 494 | Valine → Isoleucine | 1 (0.6) | 0 | 1 (0.4) | ||
| 622 | Arginine → Isoleucine | 42 (24.7) | 10 (11.5) | 52 (20.2) | ||
| 625 | Glycine → Arginine | 1 (0.6) | 6 (6.9) | 7 (2.7) | ||
| 622/625 | Arginine → Isoleucine / Glycine → Arginine | 1 (0.6) | 2 (2.3) | 3 (1.2) | ||
| 622/494 | Arginine → Isoleucine / Valine → Isoleucine | 1 (0.6) | 0 | 1 (0.4) | ||
| 494/658 |
Valine → Isoleucine / Lysine → Threonine |
1 (0.6) |
0 |
1 (0.4) |
||
| Pfcrt |
72 | Cysteine | 170 (100) | 87 (100) | 257 (100) | NA |
| Serine | NA | NA | NA | |||
| 74 | Methionine | 124 (73) | 44 (51) | 168 (65) | 0.0004 | |
| Isoleucine | 46 (27) | 43 (49) | 89 (35) | |||
| 75 | Asparagine | 124 (73) | 44 (51) | 168 (65) | 0.0004 | |
| Glutamic acid | 46 (27) | 43 (49) | 89 (35) | |||
| 76 | Lysine | 124 (73) | 44 (51) | 168 (65) | 0.0004 | |
| Threonine | 46 (27) | 43 (49) | 89 (35) | |||
| 93 | Threonine | 170 (100) | 86 (99) | 256 (99.6) | 0.2 | |
| Serine | 0 | 1 (1) | 1 (0.4) | |||
| 356 |
Isoleucine | 169 (99) | 85 (98) | 254 (98.8) | 0.2 |
|
| Threonine |
1 (1) |
2 (2) |
3 (1.2) |
|||
| Pfmdr-1 |
86 | Asparagine | 145 (85) | 75 (86) | 220 (86) | 0.8 |
| Tyrosine | 25 (15) | 12 (14) | 37 (14) | |||
| 184 | Tyrosine | 20 (12) | 14 (16) | 34 (13) | 0.3 | |
| Phenylalanine | 150 (88) | 73 (84) | 223 (87) | |||
| 1034 | Serine | 139 (82) | 70 (80) | 209 (81) | 0.8 | |
| Cysteine | 31 (18) | 17 (20) | 48 (19) | |||
| 1042 | Asparagine | 170 (100) | 87 (100) | 257 (100) | NA | |
| Aspartic acid | NA | NA | NA | |||
| 1246 |
Aspartic acid | 170 (100) | 87 (100) | 257 (100) | NA |
|
| Tyrosine |
NA |
NA |
NA |
|||
| dhfr |
51 | Asparagine | 79 (46) | 16 (18) | 95 (37) | <0.0001 |
| Isoleucine | 91 (54) | 71 (82) | 162 (63) | |||
| 59 | Cysteine | 151 (90) | 76 (87) | 227 (89) | 0.4 | |
| Arginine | 16 (10) | 11 (13) | 27 (11) | |||
| 108 | Serine | 72 (42) | 22 (25) | 94 (37) | 0.007 | |
| Asparagine | 98 (58) | 65 (75) | 163 (63) | |||
| 164 |
Isoleucine | 170 (100) | 87 (100) | 257 (100) | NA |
|
| Leucine |
NA |
NA |
NA |
|||
| dhps | 431 | Isoleucine | 170 (100) | 87 (100) | 257 (100) | NA |
| Valine | NA | NA | NA | |||
| 436 | Serine | 167 (98) | 83 (95) | 250 (97) | 0.2 | |
| Alanine | 3 (2) | 4 (5) | 7 (3) | |||
| 437 | Alanine | 30 (18) | 35 (40) | 65 (25) | 0.0001 | |
| Glycine | 140 (82) | 52 (60) | 192 (75) | |||
| 540 | Lysine | 162 (95) | 72 (83) | 234 (91) | 0.0009 | |
| Glutamic acid | 8 (5) | 15 (17) | 23 (9) | |||
| 581 | Alanine | 170 (100) | 87 (100) | 257 (100) | NA | |
| Glycine | NA | NA | NA | |||
| 613 | Alanine | 169 (99) | 86 (99) | 255 (99) | 0.6 | |
| Serine | 1 (1) | 1 (1) | 2 (1) | |||
*p values indicate the difference in percentages between sites. NA, not available. †Pfkelch13 622I/625R, 1 sample from Al Jazirah and 2 samples from Al Qadarif; Pfkelch13 494I/622I, 1 sample from Al Jazirah; Pfkelch13 494I/658T, 1 sample from Al Jazirah.
Page created: April 25, 2025
Page updated: May 27, 2025
Page reviewed: May 27, 2025
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.