Diagnosis and treatment of Plasmodium falciparum infections are required for effective malaria control and are pre-requisites for malaria elimination efforts; hence we need to monitor emergence, evolution and spread of drug- and diagnostics-resistant parasites. We deep sequenced key drug-resistance mutations and 1,832 SNPs in the parasite genomes of 609 malaria cases collected during a diagnostic-resistance surveillance study in Ethiopia. We found that 8.0% (95% CI 7.0–9.0) of malaria cases were caused by P. falciparum carrying the candidate artemisinin partial-resistance kelch13 ( K13 ) 622I mutation, which was less common in diagnostic-resistant parasites mediated by histidine-rich proteins 2 and 3 ( pfhrp2/3 ) deletions than in wild-type parasites ( P = 0.03). Identity-by-descent analyses showed that K13 622I parasites were significantly more related to each other than to wild type ( P < 0.001), consistent with recent expansion and spread of this mutation. Pfhrp2/3- deleted parasites were also highly related, with evidence of clonal transmissions at the district level. Of concern, 8.2% of K13 622I parasites also carried the pfhrp2/3 deletions. Close monitoring of the spread of combined drug- and diagnostic-resistant parasites is needed. Plasmodium falciparum candidate artemisinin partial-resistance Kelch13 622I mutation co-occurs with pfhrp2/3 deletions in Ethiopia.
【저자키워드】 Infectious-disease diagnostics, Parasite genomics,