@article{fdi:010090641,
  title = {{M}olecular markers of artemisinin resistance during falciparum malaria elimination in {E}astern {M}yanmar},
  author = {{T}hu, {A}. {M}. and {P}hyo, {A}. {P}. and {P}ateekhum, {C}. and {R}ae, {J}. {D}. and {L}andier, {J}ordi and {P}arker, {D}. {M}. and {D}elmas, {G}. and {W}atthanaworawit, {W}. and {M}c{L}ean, {A}. {R}. {D}. and {A}rya, {A}. and {R}eyes, {A}. and {L}i, {X}. and {M}iotto, {O}. and {S}oe, {K}. and {A}shley, {E}. {A}. and {D}ondorp, {A}. and {W}hite, {N}. {J}. and {D}ay, {N}. {P}. and {A}nderson, {T}. {J}. {C}. and {I}mwong, {M}. and {N}osten, {F}. and {S}mithuis, {F}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {A}rtemisinin resistance in {P}lasmodium falciparum threatens global malaria elimination efforts. {T}o contain and then eliminate artemisinin resistance in {E}astern {M}yanmar a network of community-based malaria posts was instituted and targeted mass drug administration ({MDA}) with dihydroartemisinin-piperaquine (three rounds at monthly intervals) was conducted. {T}he prevalence of artemisinin resistance during the elimination campaign (2013-2019) was characterized. {M}ethods {T}hroughout the six-year campaign {P}lasmodium falciparum positive blood samples from symptomatic patients and from cross-sectional surveys were genotyped for mutations in kelch-13-a molecular marker of artemisinin resistance. {R}esult {T}he program resulted in near elimination of falciparum malaria. {O}f 5162 {P}. falciparum positive blood samples genotyped, 3281 (63.6%) had {K}13 mutations. {T}he prevalence of {K}13 mutations was 73.9% in 2013 and 64.4% in 2019. {O}verall, there was a small but significant decline in the proportion of {K}13 mutants (p < 0.001). {I}n the {MDA} villages there was no significant change in the {K}13 proportions before and after {MDA}. {T}he distribution of different {K}13 mutations changed substantially; {F}446{I} and {P}441{L} mutations increased in both {MDA} and non-{MDA} villages, while most other {K}13 mutations decreased. {T}he proportion of {C}580{Y} mutations fell from 9.2% (43/467) before {MDA} to 2.3% (19/813) after {MDA} (p < 0.001). {S}imilar changes occurred in the 487 villages where {MDA} was not conducted. {C}onclusion {T}he malaria elimination program in {K}ayin state, eastern {M}yanmar, led to a substantial reduction in falciparum malaria. {D}espite the intense use of artemisinin-based combination therapies, both in treatment and {MDA}, this did not select for artemisinin resistance.},
  keywords = {{P}. falciparum ; {M}ass drug administration ; {K}elch13 ; {A}rtemisinin ; resistance ; {M}alaria elimination ; {MYANMAR}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {23},
  numero = {1},
  pages = {138 [11 p.]},
  year = {2024},
  DOI = {10.1186/s12936-024-04955-6},
  URL = {https://www.documentation.ird.fr/hor/fdi:010090641},
}