The first known case of artemisinin resistance in Africa has been identified, a finding of great significance for efforts in global malaria control and drug resistance monitoring. A large international team that included KAUST scientists identified the African origin of drug-resistant malaria parasites detected in a Chinese patient who traveled from Equatorial Guinea to China.

Artemisinin-based combination therapy (ACT) is the first-line recommended malaria treatment and comprises artemisinin and another antimalarial drug. Normally ACT clears the parasites from the blood within three days; however, strains of the malaria-causing agent Plasmodium falciparum in Southeast Asia have recently become relatively tolerant to artemisinin. The resistance is partial and the majority of patients can be cured, albeit with a considerable delay. But malariologists, including experts from the World Health Organization, fear that P. falciparum might eventually develop complete resistance to artemisinin as it has to other antimalarials.

The study, which was led by Jun Cao from the Jiangsu Institute for Parasitic Diseases, China, confirmed the parasite carried a new mutation in a gene called Kelch13 (K13), the main driver for artemisinin resistance in Asia. Arnab Pain, KAUST professor of bioscience, and his Ph.D. student Abhinay Ramaprasad then set out to determine whether the parasite originated from Africa or Southeast Asia.

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