Polymorphisms of Plasmodium falciparum k13-propeller gene among migrant workers returning to Henan Province, China from Africa

Abstract

BackgroundHenan Province has been in the malaria elimination stage, with all reports of the disease being imported since 2012 and over 90% coming from Africa. Surveillance and population studies are essential for the early detection and subsequent prevention of the spread of drug resistance. The K13-propeller gene was recently identified as a proposed molecular marker of artemisinin (ART) resistance. In this study, we detected mutations of the K13-propeller gene in samples taken from imported malaria cases in Henan Province from 2012 to 2015.MethodsThere were 483 samples that were obtained from Plasmodium falciparum–infected malaria migrant workers who returned to Henan Province from Africa between 2012 and 2015. The single nucleotide polymorphisms in the K13-propeller gene were assessed by nested PCR with DNA sequencing. Frequency and geographic difference of K13-propeller gene mutant types were analyzed.ResultsOf 483 patients, 476 were cured and 7 died. There were no K13-propeller mutations in the blood samples from the 7 patients who died, but there were 23 different genotypes of the K13-propeller that were observed in 24 (4.97%) of the samples. C580Y, which was the predominant one in the resistance of ART, was not detected in the samples, but R539T and P574L which have also been associated with ART resistance, were observed in two samples from Angola and Equatorial Guinea. No mutations were detected in 11 samples from North Africa. The frequency of the K13-propeller was 6.50% (8/123) in Central Africa, followed by East Africa (1/19, 5.26%), West Africa (9/198, 4.55%) and South Africa (6/132, 4.55%). There was no significant difference among these four areas (P = 0.795).ConclusionR539T and P574L were found in migrant workers who traveled from Africa to Henan Province, although the frequency of the K13-propeller mutants was low. These data may enrich the molecular surveillance of antimalarial resistance and will be helpful for developing and updating the antimalarial policy in Henan Province.

Surveillance of Antimalarial Resistance Molecular Markers in Imported Plasmodium falciparum Malaria Cases in Anhui, China, 2012–2016

“…But, the exact place of the infection can not be confirmed now, because we lost contact with the patient in 2013. samples returned to China from Africa. 11,20 Our data indicate that the most prevalent African mutation was A578S, whereas other mutations had low prevalence. This puts our findings in line with those reported by Ménard et al, 17 whereby many K13-propeller mutations appeared to be neutral and failed to undergo clonal expansion in Africa.…”

Molecular surveillance of putative drug resistance markers of antifolate and artemisinin among importedPlasmodium falciparumin Qatar

“…The mutations of Pfk13-propeller are well established in Southeast Asia, whereas only limited polymorphisms of Pfk13-propeller are detected in Africa [16,46]. Recently, in China, polymorphism in Pfk13 was reported in returned migrant workers from Africa [47]. Thus, there is now a clear need to acquire a greater understanding of Plasmodium parasites' genotypic resistance surveillance with k13-propeller polymorphism.…”

Molecular assessment of kelch13 non-synonymous mutations in Plasmodium falciparum isolates from Central African Republic (2017–2019)

“…Africa [20]. The only previous data on PfKelch13 polymorphism performed in 2014 in the CAR (K13 artemisinin resistance multicenter resistance, KARMA study), revealed a 4.5% prevalence of nonsynonymous mutations [12].…”

“…Guinea and in Rwanda, whereas mutations potentially associated with artemisinin resistance (M476I) have been detected in Senegal [20,21,22,23]. A particular case was the observation of a local mutation (M579I) in Equatorial Guinea [24].…”