Malaria parasites in Uganda show shift toward higher artemisinin resistance levels

A repeated cross-sectional study in Gulu, northern Uganda compared ex vivo artemisinin susceptibility of Plasmodium falciparum isolates from 2014-2015 and 2022-2024 using a quantitative ring-stage survival assay (qRSA) across multiple dihydroartemisinin concentrations. The study reports a population-level shift toward higher qRSA resistance levels after the known emergence of artemisinin partial resistance, with kelch13 A675V mutants showing the highest resistance level and C469Y mutants and even wild-type isolates also showing increased survival at higher drug concentrations. The authors state that multi-concentration RSA may detect early changes in artemisinin susceptibility not captured by conventional binary resistance classifications.

Most relevant for: Clinicians and researchers involved in malaria treatment and surveillance in East Africa, particularly regarding emerging artemisinin partial resistance in Plasmodium falciparum.

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