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Molecular Epidemiology of Malaria in Cameroon and Côte d'Ivoire. XXXI. Kelch 13 Propeller Sequences in Plasmodium falciparum Isolates before and after Implementation of Artemisinin-Based Combination Therapy

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  • 1 Laboratoire de Pharmacodynamie Biochimique, UFR Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire;
  • | 2 Département de Parasitologie-Mycologie, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire;
  • | 3 Unité Mixte de la Recherche 216, Mère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Développement (IRD), Unité de Formation et de Recherche (UFR) de Pharmacie, Université Paris Descartes, Paris, France;
  • | 4 PRES Sorbonne Paris Cité, Université Paris Descartes Faculté de Pharmacie, Paris, France;
  • | 5 Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon;
  • | 6 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Aix-Marseille Université, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France

Artemisinin-resistant malaria has not been reported from Africa, but resistance can possibly spread from Asia or arise independently in Africa. The emergence of artemisinin resistance in Africa can be monitored by molecular assay of Kelch 13 (K13) propeller sequences. A total of 251 archived DNA samples of Plasmodium falciparum isolates collected in 2002, 2003, and 2006 in Yaounde, Cameroon, and 47 samples collected in 2006 and 2013 in Abidjan, Côte d'Ivoire, were analyzed for K13-propeller sequence polymorphism. Only one isolate carried a mutant K13-propeller allele (E602D). None of the isolates carried the key mutant alleles (Y493H, R539T, I543T, and C580Y) associated with artemisinin resistance in Cambodia. The presence of the mutant allele was not correlated with in vitro response to dihydroartemisinin determined by the classical hypoxanthine incorporation assay. There was no evidence of K13 mutations associated with artemisinin resistance before and soon after the introduction of artemisinin-based combination therapies in Cameroon and Côte d'Ivoire.

Author Notes

Address correspondence to Rachida Tahar, Unité Mixte de la Recherche 216, Mère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Développement (IRD), Unité de Formation et de Recherche (UFR) de Pharmacie, Université Paris Descartes, 4 Avenue de l'Observatoire, 75270 Paris, France. E-mail: rachida.tahar@ird.fr

Financial support: This study was supported by Expertise France (5% Initiative grant) and the WHO Global Fund through the National Program for Malaria Control (Côte d'Ivoire).

Authors' addresses: Joseph Allico Djaman, Dagnogo Olefongo, and Aristide Berenger Ako, Laboratoire de Pharmacodynamie Biochimique, UFR Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, and Département de Parasitologie-Mycologie, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire. Jocelyne Roman, Unité Mixte de la Recherche 216, Mère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Développement (IRD), Unité de Formation et de Recherche (UFR) de Pharmacie, Université Paris Descartes, Paris, France, and PRES Sorbonne Paris Cité, Université Paris Descartes Faculté de Pharmacie, Paris, France. Vincent Foumane Ngane, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon. Leonardo K. Basco, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon, and Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Aix-Marseille Université, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France. Rachida Tahar, Unité Mixte de la Recherche 216, Mère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Développement (IRD), Unité de Formation et de Recherche (UFR) de Pharmacie, Université Paris Descartes, Paris, France, and Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon, E-mail: rachida.tahar@ird.fr.

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