Spatial surveillance of Plasmodium falciparum Kelch 13 mutations reveals High-Frequency A675V and the First Molecular Evidence of Suspected Partial Artemisinin Resistance in Baringo in Kenya.
10 affiliations
- 1Kenya Medical Research Institute (KEMRI)/Walter Reed Army Institute of Research - Africa, Kisumu, Kenya. [email protected].
- 2Department of Emerging and Infectious Diseases, Walter Reed Army Institute of Research-Africa/Centre for Clinical Research, Kenya Medical Research Institute, P. O. Box 54, Kisumu, 40100, Kenya. [email protected].
- 3Kenya Medical Research Institute (KEMRI)/Walter Reed Army Institute of Research - Africa, Kisumu, Kenya.
- 4Walter Reed Army Institute of Research - Africa, Nairobi, Kenya.
- 5Division of National Malaria Programme, Ministry of Health, Nairobi, Kenya.
- 6University of New Mexico School of Medicine, Albuquerque, NM, USA.
- 7Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
- 8Kenya Ministry of Defense, Nairobi, Kenya.
- 9Department of Pathology and Area Laboratory Services, Tripler Army Medical Center, Honolulu, HI, USA.
- 10Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
Abstract
Background
This surveillance study evaluated the polymorphisms of Pfk13 gene in samples from symptomatic individuals from eight geographically distinct locations in Kenya to determine the prevalence of mutations associated with partial artemisinin resistance.Methods
Between 2018 and 2024, blood samples from individuals with symptoms of uncomplicated malaria at eight hospitals in four of the five distinct malaria transmission zones of Kenya were sequenced for single-nucleotide polymorphisms (SNPs) in Pfk13 and Pfmdr1. Subsequent positive samples were tested to monitor treatment outcomes.Results
A total of 44/675 (3.0%) samples harbored 49 Pfk13 mutations. These include 14 nonsynonymous mutations at Pfk13: A675V (n = 3.0%) A578S (n = 4, 0.6%), C469Y (n = 3, 0.44%), V386A (n = 1, 0.15%), P553L (n = 1, 0.15%), R561H/P (n = 1, 0.15%), S522C (n = 1, 0.15%), K455E (n = 1, 0.15%), S600F (n = 1, 0.15%), E612D (n = 1, 0.15%), N489K (n = 1, 0.15%), F491L (n = 1, 0.15%) plus A504V (n = 1, 0.15%). Four WHO-validated markers of partial artemisinin resistance were detected in 25/675 (3.7%) samples. Most Pfk13 A675V mutations (n = 12, 1.8%), constituting 60% of all Pfk13 mutations observed by this study were detected in Baringo County, where the mutation frequency reached 12/71 (16.9%), exceeding the WHO 5% threshold for classification of areas with suspected partial artemisinin resistance. This represents the first molecular evidence consistent with suspected artemisinin resistance in Baringo County. CONCLUSION: The detection of four WHO-validated Pfk13 markers of partial artemisinin resistance across multiple malaria transmission zones indicates emerging artemisinin resistance in Kenya. The high frequency of A675V in Baringo provides the first molecular evidence consistent with suspected partial artemisinin resistance in Kenya and highlights the need for enhanced therapeutic efficacy, deployment of Multiple First-line Therapies, and molecular surveillance.
Related
- Efficacy of artemisinin derivatives and kelch13 mutations in Plasmodium falciparum: a systematic review and meta-analysis
- First Detection of WHO-validated artemisinin resistance Plasmodium falciparum K13 C469Y mutation in patient from Senegal.
- Association between Plasmodium falciparum Kelch13 mutations and malaria parasite clearance half-life after artemisinin-based therapy: an updated WWARN systematic review and individual patient data meta-analysis
- Molecular Surveillance of Antimalarial Drug Resistance-Associated Mutations in P. falciparum Imported from Africa into Guangdong Province, China, 2023-2025.
- Genomic Surveillance Reveals Clusters of Plasmodium falciparum Antimalarial Resistance Markers in Eswatini, A Low-Transmission Setting
BibTeX
@article{akala2026spatial,
title = {{Spatial surveillance of Plasmodium falciparum Kelch 13 mutations reveals High-Frequency A675V and the First Molecular Evidence of Suspected Partial Artemisinin Resistance in Baringo in Kenya.}},
author = {Hoseah M Akala and Benjamin H Opot and Dennis W Juma and Raphael O Okoth and Maurine Mwalo and Joseph G Amwoma and Farid A Salim and Risper Maisiba and Redemptah Yeda and Edwin W Mwakio and Gladys Chemwor and Jackline A Juma and Charles O Okudo and Timothy E Egbo and Doris Njoroge and Michal M Ohaga and Agnes C Cheruiyot and Regina Kandie and Kibor Keitany and Sammy Mahugu and Kristan A Schneider and Victor Osoti and Kevin Wamae and Milton A Obilo and George K Ng'ang'a and Eric C Garges and Ben Andagalu and Edwin Kamau and Lynette Isabella Ochola-Oyier and Bernhards R Ogutu},
journal = {Malaria journal},
year = {2026},
month = oct,
doi = {10.1186/s12936-026-06102-9},
url = {https://europepmc.org/article/MED/42963786},
note = {CC BY},
}
RIS
TY - JOUR
TI - Spatial surveillance of Plasmodium falciparum Kelch 13 mutations reveals High-Frequency A675V and the First Molecular Evidence of Suspected Partial Artemisinin Resistance in Baringo in Kenya.
AU - Hoseah M Akala
AU - Benjamin H Opot
AU - Dennis W Juma
AU - Raphael O Okoth
AU - Maurine Mwalo
AU - Joseph G Amwoma
AU - Farid A Salim
AU - Risper Maisiba
AU - Redemptah Yeda
AU - Edwin W Mwakio
AU - Gladys Chemwor
AU - Jackline A Juma
AU - Charles O Okudo
AU - Timothy E Egbo
AU - Doris Njoroge
AU - Michal M Ohaga
AU - Agnes C Cheruiyot
AU - Regina Kandie
AU - Kibor Keitany
AU - Sammy Mahugu
AU - Kristan A Schneider
AU - Victor Osoti
AU - Kevin Wamae
AU - Milton A Obilo
AU - George K Ng'ang'a
AU - Eric C Garges
AU - Ben Andagalu
AU - Edwin Kamau
AU - Lynette Isabella Ochola-Oyier
AU - Bernhards R Ogutu
PY - 2026
DA - 2026/10/05
JO - Malaria journal
DO - 10.1186/s12936-026-06102-9
UR - https://europepmc.org/article/MED/42963786
AB - Background This surveillance study evaluated the polymorphisms of Pfk13 gene in samples from symptomatic individuals from eight geographically distinct locations in Kenya to determine the prevalence of mutations associated with partial artemisinin resistance.Methods Between 2018 and 2024, blood samples from individuals with symptoms of uncomplicated malaria at eight hospitals in four of the five distinct malaria transmission zones of Kenya were sequenced for single-nucleotide polymorphisms (SNPs) in Pfk13 and Pfmdr1. Subsequent positive samples were tested to monitor treatment outcomes.Results A total of 44/675 (3.0%) samples harbored 49 Pfk13 mutations. These include 14 nonsynonymous mutations at Pfk13: A675V (n = 3.0%) A578S (n = 4, 0.6%), C469Y (n = 3, 0.44%), V386A (n = 1, 0.15%), P553L (n = 1, 0.15%), R561H/P (n = 1, 0.15%), S522C (n = 1, 0.15%), K455E (n = 1, 0.15%), S600F (n = 1, 0.15%), E612D (n = 1, 0.15%), N489K (n = 1, 0.15%), F491L (n = 1, 0.15%) plus A504V (n = 1, 0.15%). Four WHO-validated markers of partial artemisinin resistance were detected in 25/675 (3.7%) samples. Most Pfk13 A675V mutations (n = 12, 1.8%), constituting 60% of all Pfk13 mutations observed by this study were detected in Baringo County, where the mutation frequency reached 12/71 (16.9%), exceeding the WHO 5% threshold for classification of areas with suspected partial artemisinin resistance. This represents the first molecular evidence consistent with suspected artemisinin resistance in Baringo County. CONCLUSION: The detection of four WHO-validated Pfk13 markers of partial artemisinin resistance across multiple malaria transmission zones indicates emerging artemisinin resistance in Kenya. The high frequency of A675V in Baringo provides the first molecular evidence consistent with suspected partial artemisinin resistance in Kenya and highlights the need for enhanced therapeutic efficacy, deployment of Multiple First-line Therapies, and molecular surveillance.
SN - 1475-2875
ER -