Abstract
Antimalarial drug resistance has emerged as a major threat to global malaria control efforts, particularly in the Greater Mekong Subregion (GMS). In this study, we analyzed the polymorphism and prevalence of molecular markers associated with resistance to first-line antimalarial drugs, such as artemisinin, chloroquine, and pyrimethamine, using blood samples collected from malaria patients in the China–Myanmar border region of the GMS from 2008 to 2017, including 225 cases of Plasmodium falciparum and 194 cases of Plasmodium vivax. In artemisinin resistance, only the C580Y mutation with low frequency was detected in pfk13, and no highly frequent stable mutation was found in pvk12. In chloroquine resistance, the frequency of K76T mutation in pfcrt was always high, and the frequency of double mutations in pvmdr1 of P. vivax has been steadily increasing every year. In pyrimidine resistance, pfdhfr and pvdhfr had relatively more complex mutant types associated with drug resistance sites, and the overall mutation rate was still high. Therefore, artemisinin-based combination therapies are still suitable for use as the first choice of antimalarial strategy in the China–Myanmar border region in the future.
Highlights
Malaria is one of the major life-threatening infectious diseases in humans and is prevalent in tropical and subtropical regions worldwide
The P. vivax K12 gene, which is homologous to pfk13 in P. falciparum, was studied based on the mutation sites of molecular markers of artemisinin-associated resistance genes
We successfully performed a molecular surveillance of the mutation loci of the genes responsible for resistance to several first-line antimalarial drugs, such as artemisinin, CQ, and pyrimethamine, by analyzing their resistance-related gene polymorphisms in samples collected from the China–Myanmar border region from 2008 to 2017
Summary
Malaria is one of the major life-threatening infectious diseases in humans and is prevalent in tropical and subtropical regions worldwide. Humans can be infected by five species of Plasmodium, including Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and P. knowlesi (Singh and Daneshvar, 2013). P. falciparum and P. vivax have the highest incidences, followed by P. ovale and P. malariae, while some patients are infected by P. knowlesi. Almost all malaria deaths occurring in Southeast Asia have been caused by P. falciparum. Approximately 1.5 billion people were infected and 7.6 million patients died from malaria between 2000 and 2019. The majority of infections (82%) and deaths (94%) occurred
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