Genetic analysis of molecular markers is critical in tracking the emergence and/or spread of artemisinin resistant parasites. Clinical isolates collected in western Kenya pre- and post- introduction of artemisinin combination therapies (ACTs) were genotyped at SNP positions in regions of strong selection signatures on chromosome 13 and 14, as described in Southeast Asia (SEA). Twenty five SNPs were genotyped using Sequenom MassArray and pfmdr1 gene copy number by real-time PCR. Parasite clearance half-life and in vitro drug sensitivity testing were performed using standard methods. One hundred twenty nine isolates were successfully analyzed. Fifteen SNPs were present in pre-ACTs isolates and six in post-ACTs. None of the SNPs showed association with parasite clearance half-life. Post-ACTs parasites had significantly higher pfmdr1 copy number compared to pre-ACTs. Seven of eight parasites with multiple pfmdr1 were post-ACTs. When in vitro IC50s were compared for parasites with single vs. multiple gene copies, only amodiaquine and piperaquine reached statistical significance. Data showed SNPs on chromosome 13 and 14 had different frequency and trend in western Kenya parasites compared SEA. Increase in pfmdr1 gene copy is consistent with recent studies in African parasites. Data suggests genetic signature of artemisinin resistance in Africa might be different from SEA.

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Health systems have failed globally to use research evidence optimally in view of ineffective knowledge translation. Knowledge translation is the effective and timely incorporation of evidence-based information into the practices of health professionals to effect optimal health outcomes. With the growing demands on health care resources and accountability, greater emphasis is being placed on generating knowledge that can have a practical impact on decision making. This review gives an outlook of the opportunities and obstacles to knowledge translation in African context. We searched for articles published in English on the World Health Organization website, peer reviewed articles on Google Scholar, PubMed and Science Direct databases search engines since 2000 in Sub-Saharan Africa A total of 3,020 papers were analyzed and the outcomes reported. The knowledge transfer literature in African countries is widely distributed, problematically diverse and growing. However, significant disparities exist between reports in different countries while there are many settings without published evidence of local knowledge translation. Our review also highlighted the lack of meaningful investment and follow up after research findings. Barriers affecting knowledge translation includes insufficient skills and capacity to conduct knowledge transfer activities, time constraints and a lack of resources. We identified substantial geographical gaps in knowledge translation and evidence that need to boost local research capacities in Africa. Evidence mapping is a useful approach that can assist local decision-making to enhance knowledge transfer into a policy. We recommend the inclusion of knowledge translation advisors who are the advocates of the knowledge translation during protocol development.