Genomic Plasticity and Molecular Mechanisms of Antimalarial Drug Resistance in Plasmodium falciparum: Implications for Treatment Failure and Genomic Surveillance.

Authors

Anmut Assemie

Published in

BioMed research international. Volume 2026. Issue 1. Pages e9296351.

Abstract

Malaria remains a major global public health challenge, in part because Plasmodium falciparum populations can acquire and disseminate reduced susceptibility to antimalarial drugs under selective pressure. This review synthesizes current evidence on the molecular and genomic mechanisms underlying antimalarial drug resistance and examines their implications for treatment efficacy and malaria control. First, the review examines genomic plasticity, including structural genome variation, copy-number variation, recombination, epigenetic regulation, and transcriptional regulation, as sources of genetic and phenotypic variation relevant to drug susceptibility. Second, it summarizes established molecular determinants of resistance, including kelch13 (K13) mutations associated with delayed parasite clearance following artemisinin treatment, pfcrt mutations associated with chloroquine resistance, pfmdr1 copy-number variation associated with altered susceptibility to mefloquine and related antimalarials, and dhfr and dhps mutations associated with sulfadoxine-pyrimethamine resistance. Third, the review considers the emergence and dissemination of resistance-associated variants across parasite populations, emphasizing the contributions of population genomics and genomic surveillance to monitoring resistance patterns. Finally, recent applications of genomic epidemiology, whole-genome sequencing, and artificial intelligence-assisted analytical approaches are discussed, with emphasis on their potential utility for resistance surveillance and evidence-informed malaria control. Overall, integrating molecular, genomic, epidemiological, and evolutionary information provides a stronger framework for understanding antimalarial resistance and for supporting surveillance, treatment optimization, and malaria-control strategies.

PMID:
42855825
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.