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Artemisinin-based combination therapies (ACTs) are recommended for use against uncomplicated malaria in areas of multi-drug resistant malaria, such as sub-Saharan Africa. However, their long-term usefulness in these high transmission areas remains unclear. It has been suggested that documentation of the S769N  PfATPase6  mutations may indicate an emergence of artemisinin resistance of  Plasmodium falciparum  in the field. The present study assessed  PfATPase6  mutations (S769N and A623E) in 615 asymptomatic  P. falciparum  infections in Tanzania but no mutant genotype was detected. This observation suggests that resistance to artemisinin has not yet been selected in Tanzania, supporting the Ministry of Health's decision to adopt artemether+lumefantrine as first-line malaria treatment. The findings recommend further studies to assess  PfATPase6  mutations in sentinel sites and verify their usefulness in monitoring emergency of ACT resistance.

Molecular monitoring of Plasmodium falciparum resistance to artemisinin in Tanzania