biostudies-literatureUnknown60(6)Mita TThe emergence and spread of artemisinin-resistant Plasmodium falciparum is of huge concern for the global effort toward malaria control and elimination. Artemisinin resistance, defined as a delayed time to parasite clearance following administration of artemisinin, is associated with mutations in the Pfkelch13 gene of resistant parasites. To date, as many as 60 nonsynonymous mutations have been identified in this gene, but whether these mutations have been selected by artemisinin usage or merely reflect natural polymorphism independent of selection is currently unknown. To clarify this, we sequenced the Pfkelch13 propeller domain in 581 isolates collected before (420 isolates) and after (161 isolates) the implementation of artemisinin combination therapies (ACTs), from various regions of eAntimicrobial agents and chemotherapy3340-7https://www.ebi.ac.uk/biostudies/studies/S-EPMC4879392biostudies-literatureLittle Polymorphism at the K13 Propeller Locus in Worldwide Plasmodium falciparum Populations Prior to the Introduction of Artemisinin Combination Therapies.PMC4879392Ferreira MUNakamura MTsukahara TOhashi JEndo HDysoley LKobayashi JBjorkman AWin ZZMarma ASDzodzomenyo MHtike WWUemura HNdounga MHombhanje FTakahashi NHunja CWKaneko ACulleton RAkhwale WSMita TfalseLittle Polymorphism at the K13 Propeller Locus in Worldwide Plasmodium falciparum Populations Prior to the Introduction of Artemisinin Combination Therapies.The emergence and spread of artemisinin-resistant Plasmodium falciparum is of huge concern for the global effort toward malaria control and elimination. Artemisinin resistance, defined as a delayed time to parasite clearance following administration of artemisinin, is associated with mutations in the Pfkelch13 gene of resistant parasites. To date, as many as 60 nonsynonymous mutations have been identified in this gene, but whether these mutations have been selected by artemisinin usage or merely reflect natural polymorphism independent of selection is currently unknown. To clarify this, we sequenced the Pfkelch13 propeller domain in 581 isolates collected before (420 isolates) and after (161 isolates) the implementation of artemisinin combination therapies (ACTs), from various regions of e2016-01-01T00:00:00Z2016 Jun2026-05-29T20:52:26.552Z2026-04-08T06:17:13.979ZS-EPMC48793922700181410.1128/aac.02370-1510.1128/AAC.02370-15