Plasmodium falciparum non-synonymous Kelch13 mutations mediating artemisinin resistance in East Africa: A systematic review and meta-analysis: 2014–2024

Anthony Kapesa, Vito Baraka, Richard Mwaiswelo, Maria Zinga, Karol J Marwa, Eliningaya J Kweka and Erasmus Kamugisha

PLOS ONE, 2026, vol. 21, issue 7, 1-17

Abstract: Background: Resistance to antimalarial drugs has posed a significant challenge to global efforts to control and eliminate malaria. Partial artemisinin resistance has been observed in East Africa, a region that has been a historical hotspot for antimalarial drug resistance across the continent. Consequently, this review assesses the extent of non-synonymous mutations mediating artemisinin resistance, the varieties of these mutations, and their effects on treatment outcomes in East Africa. Methods: Studies reporting artemisinin resistance (samples collected between 2014 and 2024), particularly the Pf-Kelch13 mutation among malaria patients in East Africa, were searched through the Medline, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, and EMBASE online databases. The protocol for the review was registered at PROSPERO (Reference number: CRD42024602752). Two independent reviewers extracted data. Potential publication bias was assessed using a funnel plot. Pooled proportion estimates were calculated using a random-effects model, and heterogeneity was assessed using I2 statistics. Results: Twenty-four (24) studies were deemed eligible for data extraction. The heterogeneity among the studies included in the meta-analysis was high (I2 > 95% and p

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0354429

DOI: 10.1371/journal.pone.0354429

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