English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  The resistance of  Plasmodium falciparum  to artemisinin has been identified in Asia and some parts of Africa. The drug resistance of  P. falciparum  will be an obstacle to the successful elimination of malaria by 2025. Whole-genome sequencing of the artemisinin-resistant parasite line revealed mutations on the  k13  gene associated with drug resistance in  P. falciparum . To understand the artemisinin resistance of the imported  P. falciparum  cases from Africa, the mutations in the  k13  gene in parasites from imported malaria cases in Guangxi Province were detected and the treatment efficiency of artesunate monotherapy was observed.    Methods  DNA was extracted from 319 blood samples from migrant workers with  P. falciparum  infection who returned to their hometown in Guangxi Province from Africa between 2014 and 2017. The  k13 - propeller  gene was amplified by nested PCR, and sequencing, gene mutation frequency and geographic difference of imported  P. falciparum  cases were analysed by comparison with the wild-type strain. Of 319 patients, 158 were  P. falciparum -infected and were treated with intravenous injection of artesunate and were observed, including the time of asexual stage clearance and the dose of artesunate used.    Results  Of the 319  P. falciparum  samples, 12 samples had the  k13 - propeller  mutation, and 11 point mutations were detected; 5 were non-synonymous mutations (T474I, A481T, A578S, V603E, G665S) and were not associated with artemisinin resistance. The clinical treatment observation showed that the median (IQR) dose of artesunate for peripheral blood parasite asexual stage clearance was 407.55 (360–510) mg, and the D3 parasite clearance rate was 70.25%, including the five  k13 - propeller  mutations of  P. falciparum . After 7 days of treatment, 98.73% of cases were cleared. Two cases were treated with artemisinin for 8 days with a 960-mg dose to completely clear the asexual parasite, but they did not have a mutation in the  k13  gene.    Conclusions  Five mutations of the  k13 - propeller  gene in 319  P. falciparum  samples from patients returning from Africa were identified. The frequency of the  k13 - propeller  mutants was low, and the mutations were not strongly associated with artemisinin resistance. The median (IQR) dose of artesunate monotherapy in actual clinical treatment to remove asexual parasite stages was 407.55 (360–510) mg, equivalent to D3–D4. Some  P. falciparum  cases without a  k13 - propeller  mutation showed obvious delayed clearance of the parasite from peripheral blood.   Trial registration  The diagnosis of malaria and the treatment of malaria-infected patients are the routine work of Centres for Disease Control and Prevention. Information on the patients was conveyed with the patient’s approval, and the research aim, methods, risks and benefits of the study were explained in detail to the patients

malaria journal

K13-propeller gene polymorphisms of Plasmodium falciparum and the therapeutic effect of artesunate among migrant workers returning to Guangxi, China (2014–2017)