Volume 99, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Artemisinin resistance, presently confined to Southeast Asia and associated with mutations in the K13 (PfK13) propeller domain, represents a serious threat to global malaria control. This study aimed to provide baseline information for future artemisinin resistance surveillance, by analyzing the PfK13 propeller domain in field isolates collected from the Brazilian Amazon Basin between 1984 and 2011. A total of 152 mono-infections were assessed, of which 118 (78%) were collected before and 34 (22%) after the introduction of artemisinin-based combination therapy (ACT) in 2006. An 849-base pair fragment encoding the PfK13 propeller was amplified by nested polymerase chain reaction and sequenced in both directions. The sequences were compared with the reference sequence of 3D7. All samples showed wild-type sequences, thus, no mutations were observed. The results are in agreement with other recent reports and do not provide evidence for presence of PfK13 propeller domain polymorphisms associated with artemisinin resistance among field isolates in the Brazilian Amazon Basin neither before nor after the implementation of ACT.


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  1. Dondorp AM, 2009. Artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med 361: 455467. [Google Scholar]
  2. Phyo AP, 2012. Emergence of artemisinin-resistant malaria on the western border of Thailand: a longitudinal study. Lancet 379: 19601966. [Google Scholar]
  3. Kyaw MP, 2013. Reduced susceptibility of Plasmodium falciparum to artesunate in southern Myanmar. PLoS One 8: e57689. [Google Scholar]
  4. Hien TT, 2012. In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam. Malar J 11: 355. [Google Scholar]
  5. Huang F, 2015. A single mutation in K13 predominates in southern China and is associated with delayed clearance of Plasmodium falciparum following artemisinin treatment. J Infect Dis 212: 16291635. [Google Scholar]
  6. World Health Organization, 2017. Artemisinin and Artemisinin-based Combination Therapy Resistance, Status Report. Geneva, Switzerland: World Health Organization. [Google Scholar]
  7. Mita T, , 2010. Origins and spread of pfdhfr mutant alleles in Plasmodium falciparum. Acta Trop 114: 166170. [Google Scholar]
  8. Mita T, 2011. Limited geographical origin and global spread of sulfadoxine-resistant dhps alleles in Plasmodium falciparum populations. J Infect Dis 204: 19801988. [Google Scholar]
  9. Wellems TE, Hayton K, Fairhurst RM, , 2009. The impact of malaria parasitism: from corpuscles to communities. J Clin Invest 119: 24962505. [Google Scholar]
  10. Pribluda VS, Evans L, 3rd Barillas E, Marmion J, Lukulay P, Chang J, , 2014. Were medicine quality and pharmaceutical management contributing factors in diminishing artemisinin efficacy in Guyana and Suriname? Malar J 13: 77. [Google Scholar]
  11. Ministry of Health of Brazil, 2018. Boletim Malária. Brasília, Brazil: Ministry of Health of Brazil. Available at: https://public.tableau.com/profile/mal.ria.brasil#!/vizhome/MiniSivep1518_2018_06_12/casos_notificados_2018_regio_Amaznica. Accessed June 19, 2018. [Google Scholar]
  12. Ministry of Health of Brazil, 2010. Guia Prático de Tratamento da Malária no Brasil. Brasília, Brazil: Ministry of Health of Brazil. [Google Scholar]
  13. Santelli AC, 2012. Effect of artesunate-mefloquine fixed-dose combination in malaria transmission in Amazon basin communities. Malar J 11: 286. [Google Scholar]
  14. Ladeia-Andrade S, de Melo GN, de Souza-Lima Rde C, Salla LC, Bastos MS, Rodrigues PT, Luz Fd, Ferreira MU, , 2016. No clinical or molecular evidence of Plasmodium falciparum resistance to artesunate-mefloquine in northwestern Brazil. Am J Trop Med Hyg 95: 148154. [Google Scholar]
  15. Ariey F, 2014. A molecular marker of artemisinin-resistant Plasmodium falciparum malaria. Nature 505: 5055. [Google Scholar]
  16. Straimer J, 2015. Drug resistance. K13-propeller mutations confer artemisinin resistance in Plasmodium falciparum clinical isolates. Science 347: 428431. [Google Scholar]
  17. Chenet SM, 2016. Independent emergence of the Plasmodium falciparum Kelch propeller domain mutant allele C580Y in Guyana. J Infect Dis 213: 14721475. [Google Scholar]
  18. World Health Organization, 2015. Status Report on Artemisinin and ACT Resistance. Geneva, Switzerland: World Health Organization. [Google Scholar]
  19. Wooden J, Kyes S, Sibley CH, , 1993. PCR and strain identification in Plasmodium falciparum. Parasitol Today 9: 303305. [Google Scholar]
  20. Mita T, 2016. Little polymorphism at the K13 propeller locus in worldwide Plasmodium falciparum populations prior to the introduction of artemisinin combination therapies. Antimicrob Agents Chemother 60: 33403347. [Google Scholar]
  21. Ferreira MU, Castro MC, , 2016. Challenges for malaria elimination in Brazil. Malar J 15: 284. [Google Scholar]
  22. Duarte EC, Fontes CJ, Gyorkos TW, Abrahamowicz M, , 1996. Randomized controlled trial of artesunate plus tetracycline versus standard treatment (quinine plus tetracycline) for uncomplicated Plasmodium falciparum malaria in Brazil. Am J Trop Med Hyg 54: 197202. [Google Scholar]
  23. Ménard D, 2016. A worldwide map of Plasmodium falciparum K13-propeller polymorphisms. N Engl J Med 374: 24532464. [Google Scholar]
  24. Vreden SG, Jitan JK, Bansie RD, Adhin MR, , 2013. Evidence of an increased incidence of day 3 parasitaemia in suriname: an indicator of the emerging resistance of Plasmodium falciparum to artemether. Mem Inst Oswaldo Cruz 108: 968973. [Google Scholar]
  25. Musset L, Pelleau S, Girod R, Ardillon V, Carvalho L, Dusfour I, Gomes MS, Djossou F, Legrand E, , 2014. Malaria on the Guiana shield: a review of the situation in French Guiana. Mem Inst Oswaldo Cruz 109: 525533. [Google Scholar]

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  • Received : 08 Jul 2018
  • Accepted : 18 Aug 2018
  • Published online : 01 Oct 2018

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