Artemisinin Partial Resistance Mutations in Zanzibar and Tanzania Suggest Regional Spread and African Origins, 2023
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Artemisinin partial resistance (ART-R) in East Africa, driven by Plasmodium falciparum K13 mutations, threatens malaria control. Zanzibar, adjacent to Tanzania, is vulnerable to ART-R spread but lacks recent molecular surveillance. We sequenced antimalarial resistance polymorphisms from samples in Zanzibar and mainland Tanzania collected in 2022-2023. K13 mutations (P441 L , A675 V ) were found in 2/1440 Zanzibar participants and 6/3760 (R561 H , P441 L ) in mainland Tanzania. Whole genome sequencing supports the mutations African origins and regional spread. Frequent parasite importation to Zanzibar and partner drug mutation frequencies support current ACT policy but underscore the need for continued surveillance.
