Kenya ramps up malaria surveillance amid drug resistance concerns

Health researchers in Kenya are stepping up efforts to track changes in malaria parasites that could reduce the effectiveness of existing treatments.

The move follows the discovery of mutations linked to drug resistance in western Kenya, prompting a nationwide initiative to strengthen early detection and response.

The programme is coordinated by the KEMRI-Wellcome Trust Research Programme together with the Ministry of Health and the National Malaria Control Programme (NMCP).

Investigations have identified four genetic mutations associated with anti-malarial resistance spreading across eight counties in western Kenya, particularly around communities near Lake Victoria, a region with some of the highest malaria transmission rates in the country.

The surveillance is part of a malaria molecular epidemiology programme designed to generate real-time genetic data to guide public health decisions and national malaria strategies.

The approach integrates advanced molecular testing into routine malaria diagnosis through sentinel health facilities linked to the National Malaria Reference Laboratory.

Prof Isabella Oyier, Head of the Biosciences Department at KEMRI-Wellcome Trust, explained that the system allows scientists to spot genetic changes in parasites as they appear, rather than waiting for drugs to fail on a large scale.

One mutation drawing special attention is the 675 variant of concern, previously reported in Uganda, where it has been linked to slower parasite clearance after treatment with artemisinin-based drugs.

“When parasites are not cleared by day three of treatment, that raises concerns about reduced drug susceptibility,” Prof Oyier said as quoted by the Star.

Kenya continues to rely on artemisinin-based combination therapies (ACTs), such as Coartem, as the standard treatment for uncomplicated malaria.

These medicines have been vital in reducing malaria-related deaths across Africa over the last 20 years.

Prof Oyier clarified that the newly identified mutations are not evidence of confirmed treatment failure but serve as an early warning, indicating the need for closer monitoring.

To enhance the system, molecular surveillance is being embedded into routine malaria testing across the eight high-risk counties. Samples collected during normal patient care undergo advanced laboratory analyses, including next-generation sequencing, to detect genetic markers linked to resistance.

Data from the programme are shared regularly with the NMCP, helping health authorities track how frequently these mutations occur and how they spread.

“Genomic surveillance tells us the mutations are present,” Prof Oyier said. “Therapeutic efficacy trials tell us whether those mutations are actually affecting patient outcomes.”

The World Health Organisation recommends that countries with malaria conduct therapeutic efficacy trials at least every two years.

These trials evaluate whether first- and second-line treatments remain effective by measuring how quickly parasites are cleared. A key standard is parasite elimination within three days, indicating artemisinin-based treatments are working as intended.