Abstract
BackgroundMalaria control and prevention efforts continue to rely heavily on the use of medicines especially artemisinin agents. However, currently, the emergence of artemisinin resistance threatens this effort globally. The K13-gene polymorphisms associated with artemisinin resistance have been detected in Southeast Asia. In countries outside Southeast Asia, artemisinin resistance has not yet been confirmed.Methods/designThe articles will be obtained from the search of MEDLINE via PubMed, Scopus, EMBASE, and LILACS/VHL databases. Mesh terms will be used in the article search. Boolean operators (“AND”, “OR”) will be used in the article search. Article search will be done independently by two librarians (RS and AK). The articles will be screened for inclusion using set criteria and following the PRISMA guidelines. Data extraction will be done by two independent reviewers (NL and BB), Kappa statistic will be calculated, and any discrepancies resolved by discussion. Heterogeneity in the articles will be established using I2 statistic.DiscussionThis review will focus on establishing the K13-gene polymorphisms among Plasmodium falciparum parasites reported from previous studies in malaria-affected countries. Artemisinin resistance has not been widely reported among parasites in Africa and other malaria-endemic countries outside Southeast Asia. However, several studies on artemisinin resistance have reported different K13-gene polymorphisms from the validated mutations found in Southeast Asia. This study will collate evidence from previous studies on the commonly reported K13 -gene polymorphisms among P. falciparum parasites in malaria-affected countries.Systematic review registrationPROSPERO CRD 42018084624
Highlights
Malaria control and prevention efforts continue to rely heavily on the use of medicines especially artemisinin agents
This review will focus on establishing the K13-gene polymorphisms among Plasmodium falciparum parasites reported from previous studies in malaria-affected countries
Artemisinin resistance has not been widely reported among parasites in Africa and other malaria-endemic countries outside Southeast Asia
Summary
Artemisinin agents are an integral part of the current global efforts to control and eradicate malaria [12]. Monitoring of resistance to these agents faces a challenge especially outside Southeast Asia due to the lack of validated molecular markers of resistance This potentially limits the establishment of interventions to protect the efficacy of artemisinin agents [12]. The current review seeks to collate evidence on K13-gene polymorphisms commonly reported in different malaria-endemic regions of the world This will help guide in prioritizing selection of K13-gene polymorphisms outside Southeast Asia whose role in causing Plasmodium falciparum artemisinin resistance needs to be established. Therapeutic efficacy studies are considered the gold standard for establishing artemisinin resistance [14], WHO recommends that therapeutic efficacy studies be supplemented by surveillance of molecular markers of resistance [15] This is currently not possible outside Southeast Asia due to the lack of validated K13-gene polymorphisms.
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