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However, the emergence and spread of partial artemisinin resistance threatens their effectiveness for malaria treatment in sub-Saharan Africa where the burden of malaria is highest. Early detection and reporting of validated molecular markers (\n                      <jats:italic>pfk13<\/jats:italic>\n                      mutations) in\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      is useful for tracking the emergence and spread of partial artemisinin resistance to inform containment efforts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Genomic surveillance was conducted at 50 surveillance sites across four regions of Uganda in Karamoja, Lango, Acholi and West Nile from June 2021 to August 2023. Symptomatic malaria suspected patients were recruited and screened for presence of parasites. In addition, dried blood spots (DBS) were collected for parasite genomic analysis with PCR and sequencing. Out of 563 available dried blood spots (DBS), a random subset of 240\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      mono-infections, confirmed by a multiplex PCR were selected and used for detecting the\n                      <jats:italic>pfk13<\/jats:italic>\n                      mutations by Sanger sequencing using Big Dye Terminator method. Regional variations in the proportions of\n                      <jats:italic>pfk13<\/jats:italic>\n                      mutations were assessed using the chi square or Fisher\u2019s exact tests while Kruskal\u2013Wallis test was used to compare absolute parasite DNA levels between wild type and mutant parasites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 238\/240 samples (99.2%) contained sufficient DNA and were successfully sequenced. Three mutations were identified within the sequenced samples;\n                      <jats:italic>pfk13<\/jats:italic>\n                      C469Y in 32\/238 (13.5%) samples,\n                      <jats:italic>pfk13<\/jats:italic>\n                      A675V in 14\/238 (5.9%) and\n                      <jats:italic>pfk13<\/jats:italic>\n                      S522C in (1\/238 (0.42%) samples across the four surveyed regions. The prevalence of\n                      <jats:italic>pfk13<\/jats:italic>\n                      C469Y mutation was significantly higher in Karamoja region (23.3%) compared to other regions, P\u2009=\u20090.007. The majority of parasite isolates circulating in West Nile are of wild type (98.3), P\u2009=\u20090.002. Relative parasite DNA quantity did not differ in samples carrying the wild type, C469Y and A675V alleles (Kruskal\u2013Wallis test, P\u2009=\u20090.6373).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Detection of validated molecular markers of artemisinin partial resistance in multiple geographical locations in this setting provides additional evidence of emerging threat of artemisinin partial resistance in Uganda. In view of these findings, periodic genomic surveillance is recommended to detect and monitor levels of\n                      <jats:italic>pfk13<\/jats:italic>\n                      mutations in other regions in parallel with TES to assess potential implication on delayed parasite clearance and associated treatment failure in this setting. Future studies should consider identification of potential drivers of artemisinin partial resistance in the different malaria transmission settings in Uganda.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-024-05158-9","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:02:12Z","timestamp":1730811732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Emerging threat of artemisinin partial resistance markers (pfk13 mutations) in Plasmodium falciparum parasite populations in multiple geographical locations in high transmission regions of Uganda"],"prefix":"10.1186","volume":"23","author":[{"given":"Bosco B.","family":"Agaba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jye","family":"Travis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon P.","family":"Rugera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria G.","family":"Zalwango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Opigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Katureebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Mpirirwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dembo","family":"Bakary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Antonio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beshir","family":"Khalid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Ngonzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses R.","family":"Kamya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pontiano","family":"Kaleebu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Piot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"5158_CR1","volume-title":"World malaria report","author":"WHO","year":"2022","unstructured":"WHO. 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