Drug-resistant malaria mutations are spreading: 5 notes

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Drug-resistant malaria mutations are becoming increasingly prevalent in Ethiopia, potentially undermining both frontline treatments and commonly used diagnostic tests, according to an Aug. 20 study published in JAMA.

Here are five notes:

  1. Researchers found an increasing prevalence of pfhrp2 and pfhrp3 gene deletions, which can allow malaria parasites to escape detection by HRP2-based rapid diagnostic tests.
  1. Approximately 25% of successfully genotyped parasites had deletions that could allow them to evade HRP2-based tests. The findings support Ethiopia’s decision to use alternative diagnostics.
  1. The prevalence of the pfk13 R622I mutation, which is associated with artemisinin resistance, increased substantially. Researchers also identified multiple resistant parasite lineages.
  1. The study analyzed more than 2,200 patients at 20 sentinel sites across 11 regions in Ethiopia.
  1. Researchers said drug resistance was not the primary cause of Ethiopia’s recent malaria surge. The country recorded more than 10 million malaria cases in 2024, compared with fewer than 1 million in 2019.

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