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Kayiba NK, Tshibangu-Kabamba E, Rosas-Aguirre A, Kaku N, Nakagama Y, Kaneko A, Makaba DM, Malekita DY, Devleesschauwer B, Likwela JL, Zakayi PK, DeMol P, Lelo GM, Hayette MP, Dikassa PL, Kido Y, Speybroeck N. The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review. Trop Med Health 2023; 51:64. [PMID: 37968745 PMCID: PMC10647042 DOI: 10.1186/s41182-023-00551-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/16/2023] [Indexed: 11/17/2023] Open
Abstract
CONTEXT The Democratic Republic of Congo (DRC), one of the most malaria-affected countries worldwide, is a potential hub for global drug-resistant malaria. This study aimed at summarizing and mapping surveys of malaria parasites carrying molecular markers of drug-resistance across the country. METHODS A systematic mapping review was carried out before July 2023 by searching for relevant articles through seven databases (PubMed, Embase, Scopus, African Journal Online, African Index Medicus, Bioline and Web of Science). RESULTS We identified 1541 primary studies of which 29 fulfilled inclusion criteria and provided information related to 6385 Plasmodium falciparum clinical isolates (collected from 2000 to 2020). We noted the PfCRT K76T mutation encoding for chloroquine-resistance in median 32.1% [interquartile interval, IQR: 45.2] of analyzed malaria parasites. The proportion of parasites carrying this mutation decreased overtime, but wide geographic variations persisted. A single isolate had encoded the PfK13 R561H substitution that is invoked in artemisinin-resistance emergence in the Great Lakes region of Africa. Parasites carrying various mutations linked to resistance to the sulfadoxine-pyrimethamine combination were widespread and reflected a moderate resistance profile (PfDHPS A437G: 99.5% [IQR: 3.9]; PfDHPS K540E: 38.9% [IQR: 47.7]) with median 13.1% [IQR: 10.3] of them being quintuple IRN-GE mutants (i.e., parasites carrying the PfDHFR N51I-C59R-S108N and PfDHPS A437G-K540E mutations). These quintuple mutants tended to prevail in eastern regions of the country. Among circulating parasites, we did not record any parasites harboring mutations related to mefloquine-resistance, but we could suspect those with decreased susceptibility to quinine, amodiaquine, and lumefantrine based on corresponding molecular surrogates. CONCLUSIONS Drug resistance poses a serious threat to existing malaria therapies and chemoprevention options in the DRC. This review provides a baseline for monitoring public health efforts as well as evidence for decision-making in support of national malaria policies and for implementing regionally tailored control measures across the country.
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Affiliation(s)
- Nadine Kalenda Kayiba
- Research Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
- Department of Public Health, Faculty of Medicine, University of Mbujimayi, Mbujimayi, Democratic Republic of Congo
- Research Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Evariste Tshibangu-Kabamba
- Research Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Department of Internal Medicine, Faculty of Medicine, University of Mbujimayi, Mbujimayi, Democratic Republic of Congo
| | - Angel Rosas-Aguirre
- Research Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Natsuko Kaku
- Research Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yu Nakagama
- Research Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Akira Kaneko
- Research Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Dieudonné Mvumbi Makaba
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Department of Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Doudou Yobi Malekita
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Joris Losimba Likwela
- Department of Public Health, Faculty of Medicine, University of Kisangani, Kisangani, Democratic Republic of Congo
| | - Pius Kabututu Zakayi
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Patrick DeMol
- Laboratory of Clinical Microbiology, Center for Interdisciplinary Research on Medicines, University of Liège, Liège, Belgium
| | - Georges Mvumbi Lelo
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Marie-Pierre Hayette
- Laboratory of Clinical Microbiology, Center for Interdisciplinary Research on Medicines, University of Liège, Liège, Belgium
| | - Paul Lusamba Dikassa
- School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Yasutoshi Kido
- Research Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
| | - Niko Speybroeck
- Research Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
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Nana RRD, Hawadak J, Foko LPK, Kumar A, Chaudhry S, Arya A, Singh V. Intermittent preventive treatment with Sulfadoxine pyrimethamine for malaria: a global overview and challenges affecting optimal drug uptake in pregnant women. Pathog Glob Health 2023; 117:462-475. [PMID: 36177658 PMCID: PMC10337642 DOI: 10.1080/20477724.2022.2128563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Malaria in Pregnancy (MiP) leading to morbidity and mortality is a major public health problem that poses significant risk to pregnant women and their fetus. To cope with this alarming situation, administration of Sulfadoxine-pyrimethamine (SP) drugs to pregnant women as an intermittent preventive treatment (IPT) from 16 weeks of gestation is recommended by the World Health Organization (WHO) guidelines. We conducted a comprehensive search of published articles related to MiP in last 10 years with predefined keywords or their synonyms. The mapping of malaria in pregnant women showed a prevalence rate up to 35% in many countries. Although IPTp-SP has been implemented in endemic regions since several years but the IPTp-SP coverage percentage vary from country to country and continue to remain below the target of 80%. Major reasons for low IPTp-SP involve gestational age at first prenatal visit, level of education, place of residence, knowledge of IPTp-SP benefits, and use of antenatal services. Several challenges including the emergence of septuple and octuple SP-resistant parasites is reported from many countries which make the prophylactic use of IPTp-SP currently debatable. This narrative review addresses the barriers for optimal use of IPTp-SP and discusses alternative approaches to increase the use and effectiveness of SP intervention for preventing MiP. The COVID pandemic has drastically affected the public health disrupting the management of diseases worldwide. In view of this, a brief summary of COVID impact on MiP situation is also included.
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Affiliation(s)
- Rodrigue Roman Dongang Nana
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
- Parasitology laboratory, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Joseph Hawadak
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Loick Pradel Kojom Foko
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Amit Kumar
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Shewta Chaudhry
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Aditi Arya
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Vineeta Singh
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
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3
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Mbacham HF, Mosume DM, Apinjoh TO, Ntui VN, Moyeh MN, Kalaji LN, Wepnje GB, Ghogomu SM, Dionne JA, Tita ATN, Achidi EA, Anchang-Kimbi JK. Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine-pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region. Malar J 2023; 22:73. [PMID: 36864514 PMCID: PMC9979436 DOI: 10.1186/s12936-023-04485-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/10/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Plasmodium falciparum resistance to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) continues to spread throughout sub-Saharan Africa. This study assessed the occurrence of microscopic and sub-microscopic P. falciparum parasitaemia, dihydropteroate synthase mutations associated with resistance to SP and maternal anaemia in the Mount Cameroon area. METHODS Consenting pregnant women living in semi-rural and semi-urban/urbanized settings were enrolled in this cross-sectional study. Socio-demographic, antenatal and clinical data were documented. Microscopic and sub-microscopic parasitaemia were diagnosed using peripheral blood microscopy and nested polymerase chain reaction (PCR) respectively. The dhps mutations were genotyped by restriction fragment length polymorphism analysis. The presence of A437G, K540E, and A581G was considered a marker for high-level resistance. Haemoglobin levels and anaemia status were determined. RESULTS Among the women, the prevalence of microscopic and sub-microscopic P. falciparum infection were 7.7% (67/874) and 18.6% (93/500) respectively. Predictors of microscopic infection were younger age (< 21 years) (AOR = 2.89; 95% CI 1.29-6.46) and semi-rural settings (AOR = 2.27; 95% CI 1.31-3.96). Determinants of sub-microscopic infection were the rainy season (AOR, 3.01; 95% CI 1.77-5.13), primigravidity (AOR = 0.45; 95% CI 0.21-0.94) and regular ITN usage (AOR = 0.49; 95% CI 0.27-0.90). Of the145 P. falciparum isolates genotyped, 66.9% (97) carried mutations associated with resistance to SP; 33.8% (49), 0%, 52.4% (76) and 19.3% (28) for A437G, K540E, A581G and A437G + A581G respectively. The A581G mutation was associated with ≥ 3 SP doses evident only among sub-microscopic parasitaemia (P = 0.027) and multigravidae (P = 0.009). Women with microscopic infection were more likely from semi-rural settings (AOR = 7.09; 95% CI 2.59-19.42), to report history of fever (AOR = 2.6; 95% CI 1.07-6.31), to harbour parasites with double resistant mutations (AOR = 6.65; 95% CI 1.85-23.96) and were less likely to have received 2 SP doses (AOR = 0.29; 95% CI 1.07-6.31). Microscopic infection decreased Hb levels more than sub-microscopic infection. CONCLUSION The occurrence of sub-microscopic P. falciparum parasites resistant to SP and intense malaria transmission poses persistent risk of malaria infection during pregnancy in the area. ITN usage and monitoring spread of resistance are critical.
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Affiliation(s)
- Harry F Mbacham
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Diange M Mosume
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Tobias O Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Vincent N Ntui
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Marcel N Moyeh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Laken N Kalaji
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Godlove B Wepnje
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Stephen M Ghogomu
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Jodie A Dionne
- Department of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Alan T N Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, USA
| | - Eric A Achidi
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
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Kalenda NK, Tshibangu-Kabamba E, Nakagama Y, Kaku N, Kaneko A, Speybroeck N, Kido Y. Usefulness of seasonal malaria chemoprevention in the Sahel. THE LANCET. INFECTIOUS DISEASES 2023; 23:269-270. [PMID: 36327998 DOI: 10.1016/s1473-3099(22)00654-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 02/25/2023]
Affiliation(s)
- Nadine Kayiba Kalenda
- Institute of Health and Society, Faculty of Public Health, Université Catholique de Louvain, Brussels 1200, Belgium; Department of Public Health, University of Mbujimayi, Mbujimayi, DR Congo.
| | - Evariste Tshibangu-Kabamba
- Departments of Internal Medicine & Basic Sciences, University of Mbujimayi, Mbujimayi, DR Congo; Departments of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan; Research Center of Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yu Nakagama
- Departments of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan; Research Center of Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Natsuko Kaku
- Departments of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan; Research Center of Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Akira Kaneko
- Departments of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan; Research Center of Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Niko Speybroeck
- Institute of Health and Society, Faculty of Public Health, Université Catholique de Louvain, Brussels 1200, Belgium
| | - Yasutoshi Kido
- Departments of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan; Research Center of Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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5
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Nuwa A, Baker K, Bonnington C, Odongo M, Kyagulanyi T, Bwanika JB, Richardson S, Nabakooza J, Achan J, Kajubi R, Odong DS, Nakirunda M, Magumba G, Beinomugisha G, Marasciulo-Rice M, Abio H, Rassi C, Rutazaana D, Rubahika D, Tibenderana J, Opigo J. A non-randomized controlled trial to assess the protective effect of SMC in the context of high parasite resistance in Uganda. Malar J 2023; 22:63. [PMID: 36814301 PMCID: PMC9945593 DOI: 10.1186/s12936-023-04488-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/11/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Until recently, due to widespread prevalence of molecular markers associated with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) resistance in east and southern Africa, seasonal malaria chemoprevention (SMC) has not been used at scale in this region. This study assessed the protective effectiveness of monthly administration of SP + AQ (SPAQ) to children aged 3-59 months in Karamoja sub-region, Uganda, where parasite resistance is assumed to be high and malaria transmission is seasonal. METHODS A two-arm quasi-experimental, open-label prospective non-randomized control trial (nRCT) was conducted in three districts. In two intervention districts, 85,000 children aged 3-59 months were targeted to receive monthly courses of SMC using SPAQ during the peak transmission season (May to September) 2021. A third district served as a control, where SMC was not implemented. Communities with comparable malaria attack rates were selected from the three districts, and households with at least one SMC-eligible child were purposively selected. A total cohort of 600 children (200 children per district) were selected and followed using passive surveillance for breakthrough confirmed malaria episodes during the five-month peak transmission season. Malaria incidence rate per person-months and number of malaria episodes among children in the two arms were compared. Kaplan-Meier failure estimates were used to compare the probability of a positive malaria test. Other factors that may influence malaria transmission and infection among children in the two arms were also assessed using multivariable cox proportional hazards regression model. RESULTS The malaria incidence rate was 3.0 and 38.8 per 100 person-months in the intervention and control groups, respectively. In the intervention areas 90.0% (361/400) of children did not experience any malaria episodes during the study period, compared to 15% (29/200) in the control area. The incidence rate ratio was 0.078 (95% CI 0.063-0.096), which corresponds to a protective effectiveness of 92% (95% CI 90.0-94.0) among children in the intervention area. CONCLUSION SMC using SPAQ provided high protective effect against malaria during the peak transmission season in children aged 3-59 months in the Karamoja sub-region of Uganda.
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Affiliation(s)
| | - Kevin Baker
- grid.475304.10000 0004 6479 3388Malaria Consortium, London, UK ,grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Musa Odongo
- grid.452563.3Malaria Consortium Uganda, Kampala, Uganda
| | | | | | - Sol Richardson
- grid.475304.10000 0004 6479 3388Malaria Consortium, London, UK ,grid.12527.330000 0001 0662 3178Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jane Nabakooza
- grid.415705.2National Malaria Control Division, Ministry of Health, Kampala, Uganda
| | - Jane Achan
- grid.475304.10000 0004 6479 3388Malaria Consortium, London, UK
| | | | | | | | | | | | | | - Hilda Abio
- grid.452563.3Malaria Consortium Uganda, Kampala, Uganda
| | - Christian Rassi
- grid.475304.10000 0004 6479 3388Malaria Consortium, London, UK
| | - Damian Rutazaana
- grid.415705.2National Malaria Control Division, Ministry of Health, Kampala, Uganda
| | - Denis Rubahika
- grid.415705.2National Malaria Control Division, Ministry of Health, Kampala, Uganda
| | | | - Jimmy Opigo
- grid.415705.2National Malaria Control Division, Ministry of Health, Kampala, Uganda
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Wang X, Zhang X, Chen H, Lu Q, Ruan W, Chen Z. Molecular Determinants of Sulfadoxine-Pyrimethamine Resistance in Plasmodium falciparum Isolates from Central Africa between 2016 and 2021: Wide Geographic Spread of Highly Mutated Pfdhfr and Pfdhps Alleles. Microbiol Spectr 2022; 10:e0200522. [PMID: 36121226 PMCID: PMC9602997 DOI: 10.1128/spectrum.02005-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/27/2022] [Indexed: 12/31/2022] Open
Abstract
Sulfadoxine-pyrimethamine (SP) resistance impairs the efficacy of antimalarial drugs. Monitoring molecular markers in exported malaria infections provides an efficient way to trace the emergence of drug resistance in countries where malaria is endemic. Molecular markers in Pfdhfr and Pfdhps of 237 Plasmodium falciparum infections imported from central Africa between 2016 and 2021 were detected. The spatial and temporal distributions of Pfdhfr and Pfdhps mutations were analyzed. A high prevalence of Pfdhfr single-nucleotide polymorphisms (SNPs) (~92.34% to 99.10%) and a high frequency of the triple mutation haplotype I51R59N108 were observed. Cameroon, Equatorial Guinea, and Gabon showed a higher frequency (~96.61% to 100.00%) of I51R59N108 than other countries (~71.11% to 88.10%). The prevalence of C59R and I51R59N108 increased while that of other SNPs or haplotypes did not fluctuate greatly from 2016 to 2021. Large proportions of Pfdhps SNPs (A437G and K540E) were demonstrated. The SNP distribution of Pfdhps differed between countries, with S436A dominating in northern countries and A437G dominating in others. The proportions of I431V, A437G, and the triple mutant haplotype declined between 2016 and 2021, whereas the prevalence of the single mutant haplotype rose from 61.60% to 73.68%. Combinations of Pfdhfr-Pfdhps alleles conferring partial resistance, full resistance, and superresistance to SP, as defined in the text, were detected in 63.64%, 8.64%, and 0.91% of the samples, respectively. The octuple Pfdhfr-Pfdhps allele (I51R59N108-V431A436G437K540G581S613) was seen in 5.00% of the samples. We demonstrated the wide geographic spread and increasing trends in highly SP-resistant Pfdhfr genes and varying spatial patterns of Pfdhps mutants across countries in central Africa. The high prevalences of partially resistant, fully resistant, and superresistant Pfdhfr-Pfdhps combinations observed here indicated impaired SP efficacy. Increased molecular surveillance is required to monitor the changing status of the Pfdhfr and Pfdhps genes. IMPORTANCE Monitoring drug resistance is important for malaria control because its early detection enables timely action to prevent its spread and mitigate its impact. The wide geographic spread and the increasing trend of highly resistant Pfdhfr genes between 2016 and 2021 found in our study are worrisome and emphasize the urgency to monitor their updated status in central Africa. This study also illustrated the wide spread of the novel mutant Pfdhps I431V as well as the high prevalence of "partially resistant," "fully resistant," and "superresistant" Pfdhfr-Pfdhps combinations, indicating the urgent concern for SP efficacy in central Africa. These findings are alarming in central African countries where malaria is endemic, where SP was is widely used for the intermittent preventive treatment of malaria in pregnancy (IPTp) and the intermittent preventive treatment of malaria in infants below 5 years of age (IPTi), and urge enhanced molecular surveillance and responses to the threat of drug resistance.
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Affiliation(s)
- Xiaoxiao Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, People’s Republic of China
| | - Xuan Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, People’s Republic of China
| | - Hualiang Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, People’s Republic of China
| | - Qiaoyi Lu
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, People’s Republic of China
| | - Wei Ruan
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, People’s Republic of China
| | - Zhiping Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, People’s Republic of China
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Nundu SS, Simpson SV, Arima H, Muyembe JJ, Mita T, Ahuka S, Yamamoto T. It Is Time to Strengthen the Malaria Control Policy of the Democratic Republic of Congo and Include Schools and School-Age Children in Malaria Control Measures. Pathogens 2022; 11:729. [PMID: 35889975 PMCID: PMC9315856 DOI: 10.3390/pathogens11070729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023] Open
Abstract
Despite a decade of sustained malaria control, malaria remains a serious public health problem in the Democratic Republic of Congo (DRC). Children under five years of age and school-age children aged 5-15 years remain at high risk of symptomatic and asymptomatic malaria infections. The World Health Organization's malaria control, elimination, and eradication recommendations are still only partially implemented in DRC. For better malaria control and eventual elimination, the integration of all individuals into the national malaria control programme will strengthen malaria control and elimination strategies in the country. Thus, inclusion of schools and school-age children in DRC malaria control interventions is needed.
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Affiliation(s)
- Sabin S. Nundu
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; (J.-J.M.); (S.A.)
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan; (S.V.S.); (T.Y.)
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Shirley V. Simpson
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan; (S.V.S.); (T.Y.)
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Jean-Jacques Muyembe
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; (J.-J.M.); (S.A.)
| | - Toshihiro Mita
- Department of Tropical Medicine and Parasitology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan;
| | - Steve Ahuka
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; (J.-J.M.); (S.A.)
| | - Taro Yamamoto
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan; (S.V.S.); (T.Y.)
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
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Adderley J, Boulet C, McCann K, McHugh E, Ioannidis LJ, Yeoh LM. Advances in Plasmodium research, an update: highlights from the Malaria in Melbourne 2021 conference. Mol Biochem Parasitol 2022; 250:111487. [DOI: 10.1016/j.molbiopara.2022.111487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022]
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Identification of polymorphisms in genes associated with drug resistance in Plasmodium falciparum isolates from school-age children in Kinshasa, Democratic Republic of Congo. Parasitol Int 2022; 88:102541. [PMID: 35051550 DOI: 10.1016/j.parint.2022.102541] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The emergence and spread of Plasmodium falciparum parasites resistant to antimalarial drugs constitutes an obstacle to malaria control and elimination. This study aimed to identify the prevalence of polymorphisms in pfk13, pfmdr1, pfdhfr, pfdhps and pfcrt genes in isolates from asymptomatic and symptomatic school-age children in Kinshasa. METHODS Nested-PCR followed by sequencing was performed for the detection of pfk13, pfmdr1, pfdhfr, pfdhps and pfcrt polymorphisms. RESULTS Two mutations in pfk13, C532S and Q613E were identified in the Democratic Republic of Congo for the first time. The prevalence of the drug-resistance associated mutations pfcrt K76T, pfdhps K540E and pfmdr1 N86Y was low, being 27%, 20% and 9%, respectively. CONCLUSION We found a low prevalence of genetic markers associated with chloroquine and sulfadoxine-pyrimethamine resistance in Kinshasa. Furthermore, no mutations previously associated with resistance against artemisinin and is derivatives were observed in the pfK13 gene. These findings support the continued use of ACTs and IPTp-SP. Continuous molecular monitoring of antimalarial resistance markers is recommended.
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