Partner study description

TRAC is investigating the scope and spread of parasite resistance to artemisinin-based therapies at sites across Asia and Africa. The first TRAC study has been completed. This multi-centre, open-label randomised trial studied the clearance rates of peripheral blood P. falciparum parasitaemias in patients with acute uncomplicated falciparum malaria treated with two different doses of artesunate. Findings were used to validate the recently discovered kelch13 marker of artemisinin resistance. Working with MalariaGEN, TRAC samples have been sequenced and analysed for features of population genetics and signatures of selection, and contributed to the genetic basis of a genome-wide associations study for genetic markers of artemisinin resistance. Where samples were found to contain P. vivax data, for example due to mixed infection, this data was contributed to the P. vivax Genome Variation project.

Publications

• Molecular epidemiology of resistance to antimalarial drugs in the Greater Mekong subregion: an observational study
  Imwong et al
  The Lancet Infectious Diseases, 2020; 20(12) 1470-1480
  10.1016/S1473-3099(20)30228-0
• Artemisinin resistance in the malaria parasite, Plasmodium falciparum, originates from its initial transcriptional response
  Zhu et al
  Communications Biology, 2022; 5 274
  10.1038/s42003-022-03215-0
• Genomic analysis of local variation and recent evolution in Plasmodium vivax
  Pearson et al
  Nature Genetics, 2016; 48 959-964
  10.1038/ng.3599
• Genomic epidemiology of artemisinin resistant malaria
  MalariaGEN P. falciparum Community Project
  eLife, 2016; 5 e08714
  10.7554/eLife.08714
• Genetic architecture of artemisinin-resistant Plasmodium falciparum
  Miotto et al
  Nature Genetics, 2015; 47(3) 226-34
  10.1038/ng.3189
• Spread of artemisinin resistance in Plasmodium falciparum malaria
  Ashley et al.
  New England Journal of Medicine, 2014; 371(5) 411-23
  10.1056/NEJMoa1314981