{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:59:49Z","timestamp":1790351989605,"version":"4.1.0"},"reference-count":72,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:00:00Z","timestamp":1633651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Genet."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The spread of drug resistance has seriously impacted the effective treatment of infection with the malaria parasite, <jats:italic>Plasmodium falciparum<\/jats:italic>. Continuous monitoring of molecular marker polymorphisms associated with drug resistance in parasites is essential for malaria control and elimination efforts. Our study describes mutations observed in the resistance genes <jats:italic>Pfkelch13, Pfcrt<\/jats:italic>, and <jats:italic>Pfmdr1<\/jats:italic> in imported malaria and identifies additional potential drug resistance-associated molecular markers.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Chinese patients infected in Africa with <jats:italic>P. falciparum<\/jats:italic> were treated with intravenous (IV) injections of artesunate 240\u2013360 mg for 3\u20135 days while hospitalized and treated with oral dihydroartemisinin-piperaquine (DHP) for 3 days after hospital discharge. Blood samples were collected and PCR sequencing performed on genes <jats:italic>Pfkelch13, Pfcrt<\/jats:italic>, and <jats:italic>Pfmdr1<\/jats:italic> from all isolates.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> We analyzed a total of 225 patients from Guangxi, China with <jats:italic>P. falciparum<\/jats:italic> malaria acquired in Africa between 2016 and 2018. All patients were cured completely after treatment. The F446I mutation of the <jats:italic>Pfkelch13<\/jats:italic> gene was detected for the first time from samples of West African <jats:italic>P. falciparum<\/jats:italic>, with a frequency of 1.0%. Five haplotypes of <jats:italic>Pfcrt<\/jats:italic> that encode residues 72\u201376 were found, with the wild-type CVMNK sequence predominating (80.8% of samples), suggesting that the parasites might be chloroquine sensitive. For <jats:italic>Pfmdr1<\/jats:italic>, N86<jats:bold>Y<\/jats:bold> (13.1%) and Y184<jats:bold>F<\/jats:bold> (58.8%) were the most prevalent, suggesting that artemether-lumefantrine may not, in general, be a suitable treatment for the group.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> For the first time, this study detected the F446I mutation of the <jats:italic>Pfkelch13<\/jats:italic> gene from Africa parasites that lacked clinical evidence of resistance. This study provides the latest data for molecular marker surveillance related to antimalarial drug resistance genes <jats:italic>Pfkelch13, Pfcrt<\/jats:italic>, and <jats:italic>Pfmdr1<\/jats:italic> imported from Africa, in Guangxi, China from Chinese migrate workers.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration:<\/jats:bold> ChiCTROPC17013106.<\/jats:p>","DOI":"10.3389\/fgene.2021.701750","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T18:33:29Z","timestamp":1633890809000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["First Detection in West Africa of a Mutation That May Contribute to Artemisinin Resistance Plasmodium falciparum"],"prefix":"10.3389","volume":"12","author":[{"given":"Hui","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Pi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yucheng","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weilin","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maohua","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanrui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxi","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Mazier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaming","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoqing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"B2","doi-asserted-by":"publisher","first-page":"4935","DOI":"10.1128\/AAC.03055-14","article-title":"Plasmodium falciparum founder populations in western Cambodia have reduced artemisinin sensitivity in vitro","volume":"58","author":"Amaratunga","year":"","journal-title":"Antimicrob. 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