Antimalarial drug resistance has emerged as a major threat to global malaria control efforts, particularly in the Greater Mekong Subregion (GMS). In this study, we analyzed the polymorphism and prevalence of molecular markers associated with resistance to first-line antimalarial drugs, such as artemisinin, chloroquine, and pyrimethamine, using blood samples collected from malaria patients in the China-Myanmar border region of the GMS from 2008 to 2017, including 225 cases of Plasmodium falciparum and 194 cases of Plasmodium vivax. In artemisinin resistance, only the C580Y mutation with low frequency was detected in pfk13, and no highly frequent stable mutation was found in pvk12. In chloroquine resistance, the frequency of K76T mutation in pfcrt was always high, and the frequency of double mutations in pvmdr1 of P. vivax has been steadily increasing every year. In pyrimidine resistance, pfdhfr and pvdhfr had relatively more complex mutant types associated with drug resistance sites, and the overall mutation rate was still high. Therefore, artemisinin-based combination therapies are still suitable for use as the first choice of antimalarial strategy in the China-Myanmar border region in the future.

中文翻译：

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抗药性疟原虫的十年分子监测。与中缅边境隔绝。

抗疟药物耐药性已成为全球疟疾控制工作的主要威胁，特别是在大湄公河次区域 (GMS)。在本研究中，我们使用从 GMS 中缅边境地区疟疾患者采集的血液样本分析了与一线抗疟药物（如青蒿素、氯喹和乙胺嘧啶）耐药相关的分子标志物的多态性和患病率。 2008-2017年，包括恶性疟原虫225例，间日疟原虫194例。在青蒿素耐药中，pfk13中仅检测到频率较低的C580Y突变，pvk12中未发现高频率的稳定突变。在氯喹抗性中，pfcrt 中 K76T 突变的频率一直很高，而 P. vivax 每年都在稳步增加。在嘧啶耐药中，pfdhfr和pvdhfr与耐药位点相关的突变类型相对较为复杂，总体突变率仍然较高。因此，青蒿素为基础的联合疗法仍适合作为未来中缅边境地区抗疟策略的首选。