[Correspondence] Spread of a single multidrug resistant malaria parasite lineage (PfPailin) to Vietnam

The spread of artemisinin resistance in Plasmodium falciparum and the subsequent loss of partner antimalarial drugs in the Greater Mekong subregion1 presents one of the greatest threats to the control and elimination of malaria. Artemisinin resistance is associated with mutations in the PfKelch gene. Initially multiple independent Kelch mutations were observed,1 but in a recent sinister development, a single dominant artemisinin-resistant P falciparum C580Y mutant lineage has arisen in western Cambodia, outcompeted the other resistant malaria parasites, and subsequently acquired resistance to piperaquine.

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