Kirby Rebecca, Giesbrecht David, Karema Corine, Watson Oliver, Lewis Savannah, Munyaneza Tharcisse, Butera Jean De Dieu, Juliano Jonathan J, Bailey Jeffrey A, Mazarati Jean-Baptiste
Brown University, Providence, Rhode Island, USA.
Quality Equity Health Care, Kigali, Rwanda.
Open Forum Infect Dis. 2023 Mar 21;10(4):ofad149. doi: 10.1093/ofid/ofad149. eCollection 2023 Apr.
Artemisinin resistance mutations in () have begun to emerge in Africa, with R561H being the first reported in Rwanda in 2014, but limited sampling left questions about its early distribution and origin.
We genotyped positive dried blood spot (DBS) samples from a nationally representative 2014-2015 Rwanda Demographic Health Surveys (DHS) HIV study. DBS were subsampled from DHS sampling clusters with >15% prevalence, as determined by rapid testing or microscopy done during the DHS study (n clusters = 67, n samples = 1873).
We detected 476 parasitemias among 1873 residual blood spots from a 2014-2015 Rwanda Demographic Health Survey. We sequenced 351 samples: 341/351 were wild-type (97.03% weighted), and 4 samples (1.34% weighted) harbored R561H that were significantly spatially clustered. Other nonsynonymous mutations found were V555A (3), C532W (1), and G533A (1).
Our study better defines the early distribution of R561H in Rwanda. Previous studies only observed the mutation in Masaka as of 2014, but our study indicates its presence in higher-transmission regions in the southeast of the country at that time.
非洲已开始出现恶性疟原虫（Plasmodium falciparum）中的青蒿素抗性突变，R561H是2014年在卢旺达首次报道的，但由于采样有限，其早期分布和起源存在疑问。
我们对来自具有全国代表性的2014 - 2015年卢旺达人口与健康调查（DHS）艾滋病毒研究的阳性干血斑（DBS）样本进行基因分型。DBS是从DHS采样群中患病率>15%的样本中抽取的，这是根据DHS研究期间通过快速检测或显微镜检查确定的（n个群 = 67，n个样本 = 1873）。
我们在2014 - 2015年卢旺达人口与健康调查的1873个残留血斑中检测到476例疟原虫血症。我们对351个样本进行了测序：341/351为野生型（加权97.03%），4个样本（加权1.34%）携带R561H，且在空间上显著聚集。发现的其他非同义突变有V555A（3个）、C532W（1个）和G533A（1个）。
我们的研究更好地确定了R561H在卢旺达的早期分布。之前的研究截至2014年仅在马萨卡观察到该突变，但我们的研究表明当时它在该国东南部传播率较高的地区存在。
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