A Mutation Is Making It Easier for Drug-Resistant Malaria to Spread

Whole-genome sequencing of 157 Plasmodium falciparum isolates from Uganda (2016-2024) revealed a cluster of three amino-acid substitutions and two deletions in the px1 gene, named PIN, first detected in 2008. By 2024, PIN was present in 84% of northern-Uganda and 55% of eastern-Uganda samples and reduced sensitivity to lumefantrine and multiple other antimalarials, whereas px1-null parasites showed increased drug susceptibility. The study validates PIN as a molecular marker for lumefantrine resistance, recommending its use in surveillance.