Clonal expansion of artemisinin-resistant Plasmodium falciparum in Uganda is associated with sub-standard therapeutic practices

The current study assessed the prevalence of K13 mutations in the context of the large-scale roll-out of pre-referral rectal artesunate through community-based providers in Kole, Kwania and Oyam districts in Northern Uganda. We observed the emergence of the mutant C469Y in locations where this haplotype was initially undetected. Using a comparative whole-genome strategy, we confirmed the local emergence of the C469Y mutation. we found a higher tolerance of 3D7-C469Y to dihydroartemisinin compared to 3D7-WT based on the ring-stage survival assay.