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Background: Artemisinin resistance in Plasmodium falciparum has emerged in Southeast Asia and poses a threat to malaria control and elimination. Mutations in a P. falciparum gene encoding a kelch protein on chromosome 13 have been associated with delayed parasite clearance following artemisinin treatment elsewhere in the region, but not yet in China.Methods: Therapeutic efficacy studies of artesunate and dihydroartemisinin-piperaquine were conducted from 2009 to 2012 in the Yunnan Province of China near the border with Myanmar. K13 mutations were genotyped by capillary sequencing of DNA extracted from dried blood spots collected in these clinical trials and in routine surveillance. Associations between K13 mutations and delayed parasite clearance were tested using regression models.Results: Parasite clearance half-lives were prolonged after artemisinin treatment, with 44% of infections having half-lives >5 hours (n = 109). Fourteen mutations in K13 were observed, with an overall prevalence of 47.7% (n = 329). A single mutation, F446I, predominated, with a prevalence of 36.5%. Infections with F446I were significantly associated with parasitemia on day 3 following artemisinin treatment and with longer clearance half-lives.Conclusions: Plasmodium falciparum infections in southern China displayed markedly delayed clearance following artemisinin treatment. F446I was the predominant K13 mutation and was associated with delayed parasite clearance. [ABSTRACT FROM AUTHOR]

The susceptibility of adults and larvae from four field populations of Culex pipiens pallens (Coguillett) (Diptera: Culicidae) in China to deltamethrin, beta-cypermethrin, and permethrin was investigated using the World Health Organization standard susceptibility test methods. One to 2 d old nonblood fed female mosquitoes emerged from pupae resulting from wild-caught larvae (F1 laboratory reared adults) were exposed to various doses of the pyrethroids. The larval bioassay was conducted using a range of concentrations to determine the LC50 values. Using allele-specific polymerase chain reaction, the frequency of the kdr resistance gene was determined in each population. The bioassay data indicated that deltamethrin was the most active larvicide in all four populations with resistance ratios (RR) of 1.6-3.9-fold. This was followed by beta-cypermethrin with RR of 1.1 -3.3-fold, while larvae from three mosquito populations from Beijing, Jinan, and Kaifeng had developed resistance to permethrin with RR of 12.6-, 24.0-, and 18.8-fold, respectively. The overall RR of larvae for all insecticides in ascending order was Changchun < Beijing < Kaifeng < Jinan; and ranking of the adult mortality was Changchun < Jinan = Kaifeng < Beijing. For the three pyrethroids tested, the correlation coefficient among the three test methods on the four populations and one lab strain was quite weak. The R value was 0.113-0.320 when we compared kdr detection for kdr% with LC50, -0.565 to -0.793 when kdr% versus adult mortality test, and -0.750 to 0.505 for LC50 versus adult mortality. Permethrin showed the best correlation (R = -0.793) between kdr frequency and adult mortality. This indicates that levels of susceptibility changes to an insecticide should not be based on a single method of assessment. [ABSTRACT FROM AUTHOR]