What question did this study set out to answer?

March 21, 2026American Journal of Tropical Medicine and Hygiene1 citationsOpen Access

Emerging Artemisinin Partial Resistance in Southern Africa

RMRosario Martinez-Vega DIDeus Ishengoma RGRoly Gosling

Key Points

This research aims to highlight the emergence of artemisinin partial resistance in southern Africa and its implications for malaria treatment.
Identified the P441L mutation in the Plasmodium falciparum Kelch13 gene.
Conducted prevalence studies in specific sites across Angola, Namibia, and Zambia.
Utilized molecular surveillance through the Genomics of Malaria in the Elimination 8 project.
Prevalence of the P441L mutation was found to be 7.3% in Angola, 33% in Namibia, and 47% in Zambia.
This represents the fourth major focus of artemisinin resistance in Africa.
Calls for immediate treatment policy adjustments and enhanced surveillance.

Abstract

A new focus of probable artemisinin-partial resistance (ART-R) has been identified in southern Africa, driven by the P441L mutation in the Plasmodium falciparum Kelch13 gene. This emerging cross-border cluster across Angola, Namibia, and Zambia represents the fourth major ART-R focus identified in Africa, adding to the previously reported foci in East Africa and the Horn of Africa. Findings from three new studies reveal 7.3%, 33%, and 47% prevalence of P441L in specific sites in Angola, Namibia, and Zambia, respectively. The Genomics of Malaria in the Elimination 8 project enabled harmonized, real-time molecular surveillance across five countries, providing actionable data for national malaria programs. Given past failures to contain chloroquine and sulfadoxine-pyrimethamine resistance, a timely response is critical. We recommend immediate treatment policy shifts, expanded surveillance, and regional coordination to prevent the spread of ART-R. This Perspective calls on global health actors to act decisively while resistance remains geographically limited.

KI fragen

Bookmark

View Full Paper