Plasmodium falciparum Kelch 13-propeller gene mutation update in Nigeria – a systematic review
Keywords:K13-propeller gene polymorphism, Artemisinin resistance, Malaria Risk, Plasmodium falciparum, Nigeria
Background: Mutations in Plasmodium falciparum Kelch 13 propeller gene has been associated with artemisinin resistance. This review is a synthesis of evidence from research on Plasmodium falciparum Kelch 13 (Pfk13) propeller gene mutations conducted in Nigeria from 2011 to 2023 to determine the extent of spread of Pfk13 mutations in different states of Nigeria.
Methods: An electronic search of studies from 2011 to date was done in Medline via PubMed, database and Google Scholar using Mesh terms and Boolean operators. PRISMA guidelines were used to guide the screening of articles for inclusion. Data extraction form was developed in Excel 2016 and used for data extraction.
Results: A total of 84 articles were retrieved but only 12 were eligible for inclusion. Pfk13 gene mutations studies have been conducted in 11 out of 36 (30.6%) states of Nigeria. The total number of independent Pfk13 mutations identified across the different states was 44, 32 (72.7%) mutations were novels. None of the reported mutations in this review was among the validated k13 mutations associated with increased artemisinin resistance.
Conclusion: Number of Pfk13 gene mutations studies in Nigeria was scanty. States in the North-east, North-west, and South-south geopolitical regions of Nigeria have the poorest coverage. Pfk13 gene mutations including novel ones were identified, however, they were all non-validated k13 mutations. There is need to carry out further studies (in vitro and in vivo) to ascertain the role of these novel mutations in emergence and spread of ART resistance in Nigeria.
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