{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:32:55Z","timestamp":1787031175297,"version":"build-2736575974"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    A new focus of probable artemisinin-partial resistance (ART-R) has been identified in southern Africa, driven by the P441L mutation in the\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    Kelch13 gene. This emerging cross-border cluster across Angola, Namibia, and Zambia represents the fourth major ART-R focus identified in Africa, adding to the previously reported foci in East Africa and the Horn of Africa. Findings from three new studies reveal 7.3%, 33%, and 47% prevalence of P441L in specific sites in Angola, Namibia, and Zambia, respectively. The Genomics of Malaria in the Elimination 8 project enabled harmonized, real-time molecular surveillance across five countries, providing actionable data for national malaria programs. Given past failures to contain chloroquine and sulfadoxine-pyrimethamine resistance, a timely response is critical. We recommend immediate treatment policy shifts, expanded surveillance, and regional coordination to prevent the spread of ART-R. This Perspective calls on global health actors to act decisively while resistance remains geographically limited.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0417","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T15:12:31Z","timestamp":1773760351000},"source":"Crossref","is-referenced-by-count":1,"title":["Emerging Artemisinin Partial Resistance in Southern Africa"],"prefix":"10.4269","author":[{"given":"Rosario","family":"Martinez-Vega","sequence":"first","affiliation":[{"name":"Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deus S.","family":"Ishengoma","sequence":"additional","affiliation":[{"name":"National Institute for Medical Research, Dar es Salaam, Tanzania;"},{"name":"Ifakara Health Institute, Dar es Salaam, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roly","family":"Gosling","sequence":"additional","affiliation":[{"name":"Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom;"},{"name":"Malaria Elimination Initiative, Institute of Global Health Sciences, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Am J Trop Med Hyg","first-page":"xxx","article-title":"Plasmodium falciparum genomic surveillance reveals a diversity of kelch13 mutations in Zambia","volume":"114","author":"Aranda-D\u00edaz","year":"2026"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"xxx","article-title":"High prevalence of molecular markers associated with Artemisinin, Sulfadoxine, and Pyrimethamine resistance in northern Namibia","volume":"114","author":"Eloff","year":"2026"},{"key":"b3","article-title":"Geographical heterogeneity in antimalarial resistance markers revealed by genomic surveillance in Angola","author":"Jo\u00e3o","year":"2026"},{"key":"b4","article-title":"The intolerable burden of malaria: A new look at the numbers","author":"Breman","year":"2001"},{"key":"b5","series-title":"Trop Med Int Health","first-page":"1086","article-title":"Impact of delayed introduction of sulfadoxine-pyrimethamine and arthemeter-lumefantrine on malaria epidemiology in KwaZulu-Natal, South Africa","volume":"14","author":"Knight","year":"2009"},{"key":"b6","series-title":"Am J Trop Med Hyg","first-page":"12","article-title":"The public health impact of chloroquine resistance in Africa","volume":"64","author":"Trape","year":"2001"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"35","article-title":"Bridging the gap from molecular surveillance to programmatic decisions for malaria control and elimination","volume":"112","author":"Golumbeanu","year":"2025"},{"key":"b8","series-title":"Nat Rev Microbiol","first-page":"373","article-title":"Emergence, transmission dynamics and mechanisms of artemisinin partial resistance in malaria parasites in Africa","volume":"22","author":"Rosenthal","year":"2024"},{"key":"b9","article-title":"Report on Antimalarial Drug Efficacy, Resistance and Response: 10 Years of Surveillance (2010\u20132019)","author":"WHO","year":"2020"},{"key":"b10","article-title":"Malaria: Artemisinin Partial Resistance","author":"WHO","year":"2025"},{"key":"b11","series-title":"Nat Commun","first-page":"530","article-title":"Artemisinin-resistant K13 mutations rewire Plasmodium falciparum\u2019s intra-erythrocytic metabolic program to enhance survival","volume":"12","author":"Mok","year":"2021"},{"key":"b12","series-title":"mBio","article-title":"Role of Plasmodium falciparum Kelch 13 protein mutations in P. falciparum populations from Northeastern Myanmar in 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infection (PCPI): A three-arm, parallel, double-blinded, placebo-controlled, randomised trial of presumptive sulfadoxine-pyrimethamine versus sulfadoxine-pyrimethamine plus amodiaquine versus artesunate monotherapy among asymptomatic children 3-5 years of age in Cameroon","volume":"24","author":"Martinez-Vega","year":"2024"},{"key":"b18","series-title":"BMC Infect Dis:","article-title":"Parasite clearance and protection from Plasmodium falciparum infection (PCPI): a two-arm, parallel, double-blinded, placebo-controlled, randomised trial of presumptive sulfadoxine-pyrimethamine versus artesunate monotherapy among asymptomatic children 3-5 years of age in Zambia","author":"Martinez-Vega","year":"2024"},{"key":"b19","series-title":"Lancet","first-page":"1345","article-title":"Triple artemisinin-based combination therapies versus artemisinin-based combination therapies for uncomplicated Plasmodium falciparum malaria: A multicentre, open-label, randomised clinical 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