Changing Antimalarial Drug Resistance Patterns Identified by Surveillance at Three Sites in Uganda.

Tumwebaze, Patrick; Tukwasibwe, Stephen; Taylor, Aimee; Conrad, Melissa; Ruhamyankaka, Emmanuel; Asua, Victor; Walakira, Andrew; Nankabirwa, Joaniter; Yeka, Adoke; Staedke, Sarah G; +5 more... Greenhouse, Bryan; Nsobya, Samuel L; Kamya, Moses R; Dorsey, Grant; Rosenthal, Philip J; (2016) Changing Antimalarial Drug Resistance Patterns Identified by Surveillance at Three Sites in Uganda. The Journal of infectious diseases, 215 (4). pp. 631-635. ISSN 0022-1899 DOI: https://doi.org/10.1093/infdis/jiw614 (In Press)

Abstract

We assessed Plasmodium falciparum drug resistance markers in parasites collected in 2012, 2013, and 2015 at 3 sites in Uganda. The prevalence and frequency of parasites with mutations in putative transporters previously associated with resistance to aminoquinolines, but increased sensitivity to lumefantrine (pfcrt 76T; pfmdr1 86Y and 1246Y), decreased markedly at all sites. Antifolate resistance mutations were common, with apparent emergence of mutations (pfdhfr 164L; pfdhps 581G) associated with high-level resistance. K13 mutations linked to artemisinin resistance were uncommon and did not increase over time. Changing malaria treatment practices have been accompanied by profound changes in markers of resistance.