{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:52:31Z","timestamp":1792018351964,"version":"4.4.0"},"reference-count":35,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4,4]]},"abstract":"<jats:p>Between 2012 and 2016, over 80% of registered malaria cases in Anhui province were <jats:italic>Plasmodium falciparum<\/jats:italic> returned from Africa. However, drug-resistance marker polymorphisms in imported <jats:italic>P. falciparum<\/jats:italic> cases have not been assessed. This study looked at the distribution of antimalarial\u2013drug resistance by evaluating K13-propeller, <jats:italic>pfmdr1<\/jats:italic>, and <jats:italic>pfcrt<\/jats:italic> gene mutations. Fourteen synonymous and 15 nonsynonymous mutations in the K13-propeller gene were detected in samples from nine African countries, yet no candidate and validated K13 resistance mutations were found. The prevalence of <jats:italic>pfcrt<\/jats:italic> K76T and <jats:italic>pfmdr1<\/jats:italic> N86Y mutants was 27.7% and 19.9%, respectively. Six different <jats:italic>pfcrt<\/jats:italic> genotypes were found, with C<jats:sub>72<\/jats:sub>V<jats:sub>73<\/jats:sub>M<jats:sub>74<\/jats:sub>N<jats:sub>75<\/jats:sub>T<jats:sub>76<\/jats:sub> being the most common (89.2%). The <jats:italic>pfcrt<\/jats:italic> 76-<jats:italic>pfmdr1<\/jats:italic> 86 haplotype combination was evaluated in 173 isolates, and the N<jats:sub>86<\/jats:sub>T<jats:sub>76<\/jats:sub> genotype was the most prevalent (50.3%). Notably, the prevalence of the N86Y mutation in Africa marked a decline from 31.0% in 2012 to 8.2% in 2016. Our findings suggest that there is no immediate threat to artemisinin efficacy in imported <jats:italic>P. falciparum<\/jats:italic> infections returned from Africa to Anhui province. Nevertheless, <jats:italic>pfcrt<\/jats:italic> K76T and <jats:italic>pfmdr1<\/jats:italic> N86Y mutations were modestly prevalent, suggesting the presence of chloroquine resistance in these cases. Accordingly, dihydroartemisinin + piperaquine may be a better choice than artesunate + amodiaquine for the treatment of uncomplicated <jats:italic>P. falciparum<\/jats:italic> infections in Anhui province. In addition to, artemether\u2013lumefantrine can be introduced as an alternative measure.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0864","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T07:00:41Z","timestamp":1518505241000},"page":"1132-1136","source":"Crossref","is-referenced-by-count":23,"title":["Surveillance of Antimalarial Resistance Molecular Markers in Imported Plasmodium falciparum Malaria Cases in Anhui, China, 2012\u20132016"],"prefix":"10.4269","volume":"98","author":[{"given":"Tao","family":"Zhang","sequence":"first","affiliation":[{"name":"Anhui Provincial Center for Disease Control and Prevention, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian","family":"Xu","sequence":"additional","affiliation":[{"name":"Anhui Provincial Center for Disease Control and Prevention, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Jiang","sequence":"additional","affiliation":[{"name":"Anhui Provincial Center for Disease Control and Prevention, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Yu","sequence":"additional","affiliation":[{"name":"Anhui Provincial Center for Disease Control and Prevention, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuicui","family":"Tian","sequence":"additional","affiliation":[{"name":"Anhui Provincial Center for Disease Control and Prevention, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Li","sequence":"additional","affiliation":[{"name":"Anhui Provincial Center for Disease Control and Prevention, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","author":"World Health Organization","year":"2016"},{"key":"b2","author":"World Health Organization","year":"2015"},{"key":"b3","series-title":"J Pathog Biol","first-page":"1142","article-title":"Advances in the study of artemisinin resistance in Plasmodium falciparum and methods of its detection","volume":"9","author":"Wang","year":"2014"},{"key":"b4","series-title":"N Engl J Med","first-page":"2619","article-title":"Evidence of artemisinin-resistant malaria in western Cambodia","volume":"359","author":"Noedl","year":"2008"},{"key":"b5","series-title":"Lancet","first-page":"1418","article-title":"Artemisinin resistance on the Thai\u2013Cambodian border","volume":"374","author":"M\u00fcller","year":"2009"},{"key":"b6","series-title":"Malar J","first-page":"1","article-title":"Prevalence of K13-propeller polymorphisms in Plasmodium falciparum from China\u2013Myanmar border in 2007\u20132012","volume":"14","author":"Wang","year":"2015"},{"key":"b7","series-title":"J Infect Dis","first-page":"670","article-title":"Independent emergence of artemisinin resistance mutations among Plasmodium falciparum in southeast Asia","volume":"211","author":"Takala-Harrison","year":"2015"},{"key":"b8","series-title":"Nature","first-page":"50","article-title":"A molecular marker of artemisinin-resistant Plasmodium falciparum malaria","volume":"505","author":"Ariey","year":"2014"},{"key":"b9","series-title":"J Infect Dis","first-page":"680","article-title":"Absence of putative artemisinin resistance mutations among Plasmodium falciparum in sub-Saharan Africa: a molecular epidemiologic study","volume":"211","author":"Taylor","year":"2015"},{"key":"b10","series-title":"J Infect Dis","first-page":"1352","article-title":"K13-propeller polymorphisms in Plasmodium falciparum parasites from sub-Saharan Africa","volume":"211","author":"Kamau","year":"2015"},{"key":"b11","series-title":"N Engl J Med","first-page":"991","article-title":"Emergence of indigenous artemisinin-resistant Plasmodium falciparum in Africa","volume":"376","author":"Lu","year":"2017"},{"key":"b12","series-title":"Antimicrob Agents Chemother","first-page":"326","article-title":"Evaluation of antimalarial resistance marker polymorphism in returned migrant workers in China","volume":"59","author":"Feng","year":"2015"},{"key":"b13","author":"World Health Organization","year":"2017"},{"key":"b14","series-title":"Antimicrob Agents Chemother","first-page":"3908","article-title":"Piperaquine resistance is associated with a copy number variation on chromosome 5 in drug-pressured Plasmodium falciparum parasites","volume":"55","author":"Eastman","year":"2011"},{"key":"b15","series-title":"Mol Microbiol","first-page":"270","article-title":"Mutations in transmembrane domains 1, 4 and 9 of the Plasmodium falciparum chloroquine resistance transporter alter susceptibility to chloroquine, quinine and quinidine","volume":"63","author":"Cooper","year":"2010"},{"key":"b16","series-title":"Malar J","first-page":"89","article-title":"A systematic review and meta-analysis of evidence for correlation between molecular markers of parasite resistance and treatment outcome in falciparum malaria","volume":"8","author":"Picot","year":"2009"},{"key":"b17","series-title":"N Engl J Med","first-page":"2453","article-title":"A worldwide map of Plasmodium falciparum K13-propeller polymorphisms","volume":"374","author":"M\u00e9nard","year":"2016"},{"key":"b18","series-title":"ADRJ","first-page":"152","article-title":"The application of artemisinin monotherapies for malaria treatment was demanded to end by WHO","volume":"8","author":"World Health Organization","year":"2006"},{"key":"b19","author":"National Health and Family Planning Commission of the People\u2019s Republic of China","year":"2009"},{"key":"b20","series-title":"BMC Infect Dis","first-page":"560","article-title":"Polymorphisms of Plasmodium falciparum k13-propeller gene among migrant workers returning to Henan Province, China from Africa","volume":"17","author":"Yang","year":"2017"},{"key":"b21","series-title":"Mol Cell","first-page":"861","article-title":"Mutations in the P. falciparum digestive vacuole transmembrane protein PfCRT and evidence for their role in chloroquine resistance","volume":"6","author":"Fidock","year":"2000"},{"key":"b22","series-title":"Science","first-page":"210","article-title":"Chloroquine resistance in Plasmodium falciparum malaria parasites conferred by pfcrt mutations","volume":"298","author":"Sidhu","year":"2002"},{"key":"b23","series-title":"Acta Trop","first-page":"181","article-title":"Contribution of the pfmdr1 gene to antimalarial drug-resistance","volume":"94","author":"Duraisingh","year":"2005"},{"key":"b24","series-title":"Mem Inst Oswaldo Cruz","first-page":"947","article-title":"Genetics of chloroquine-resistant malaria: a haplotypic view","volume":"108","author":"Awasthi","year":"2013"},{"key":"b25","series-title":"Antimicrob Agents Chemother","first-page":"7032","article-title":"Role of pfmdr1 in vitro Plasmodium falciparum susceptibility to chloroquine, quinine, monodesethylamodiaquine, mefloquine, lumefantrine, and dihydroartemisinin","volume":"58","author":"Wurtz","year":"2014"},{"key":"b26","series-title":"Mol Cell","first-page":"861","article-title":"Mutations in the P. falciparum digestive vacuole transmembrane protein PfCRT and evidence for their role in chloroquine resistance","volume":"6","author":"Fidock","year":"2000"},{"key":"b27","series-title":"Malar J","first-page":"584","article-title":"The return of chloroquine-susceptible Plasmodium falciparum malaria in Zambia","volume":"15","author":"Mwanza","year":"2016"},{"key":"b28","series-title":"Malar J","first-page":"328","article-title":"Chloroquine sensitivity: diminished prevalence of chloroquine-resistant gene marker pfcrt-76 13 years after cessation of chloroquine use in Msambweni, Kenya","volume":"14","author":"Kiarie","year":"2015"},{"key":"b29","series-title":"Acta Trop","first-page":"63","article-title":"Selection of pfmdr1 and pfcrt alleles in amodiaquine treatment failure in north-western Burkina Faso","volume":"114","author":"Danquah","year":"2010"},{"key":"b30","series-title":"Antimicrob Agents Chemother","first-page":"3908","article-title":"Piperaquine resistance is associated with a copy number variation on chromosome 5 in drug-pressured Plasmodium falciparum parasites","volume":"55","author":"Eastman","year":"2011"},{"key":"b31","series-title":"Antimicrob Agents Chemother","first-page":"7032","article-title":"Role of pfmdr1 in in vitro Plasmodium falciparum susceptibility to chloroquine, quinine, monodesethylamodiaquine, mefloquine, lumefantrine, and dihydroartemisinin","volume":"58","author":"Wurtz","year":"2014"},{"key":"b32","series-title":"Nat Commun","first-page":"11553","article-title":"Globally prevalent PfMDR1 mutations modulate Plasmodium falciparum susceptibility to artemisinin-based combination therapies","volume":"7","author":"Veiga","year":"2016"},{"key":"b33","series-title":"PLoS One","first-page":"e4551","article-title":"Changes in the treatment responses to artesunate-mefloquine on the northwestern border of Thailand during 13 years of continuous deployment","volume":"4","author":"Carrara","year":"2009"},{"key":"b34","series-title":"Proc Natl Acad Sci USA","first-page":"18883","article-title":"Geographic patterns of Plasmodium falciparum drug resistance distinguished by differential responses to amodiaquine and chloroquine","volume":"6","author":"S\u00e1","year":"2009"},{"key":"b35","series-title":"J Infect Dis","first-page":"750","article-title":"In vivo selection of Plasmodium falciparum parasites carrying the chloroquine-susceptible pfcrt K76 allele after treatment with artemether-lumefantrine in Africa","volume":"199","author":"Sisowath","year":"2009"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/4\/article-p1132.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/4\/article-p1132.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/98\/4\/article-p1132.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T15:26:42Z","timestamp":1722439602000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/98\/4\/article-p1132.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,4]]},"references-count":35,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.17-0864","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,4]]}}}