The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review
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 count...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Tropical Medicine and Health |
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| Online Access: | https://doi.org/10.1186/s41182-023-00551-7 |
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| author | Nadine Kalenda Kayiba Evariste Tshibangu-Kabamba Angel Rosas-Aguirre Natsuko Kaku Yu Nakagama Akira Kaneko Dieudonné Mvumbi Makaba Doudou Yobi Malekita Brecht Devleesschauwer Joris Losimba Likwela Pius Kabututu Zakayi Patrick DeMol Georges Mvumbi Lelo Marie-Pierre Hayette Paul Lusamba Dikassa Yasutoshi Kido Niko Speybroeck |
| author_facet | Nadine Kalenda Kayiba Evariste Tshibangu-Kabamba Angel Rosas-Aguirre Natsuko Kaku Yu Nakagama Akira Kaneko Dieudonné Mvumbi Makaba Doudou Yobi Malekita Brecht Devleesschauwer Joris Losimba Likwela Pius Kabututu Zakayi Patrick DeMol Georges Mvumbi Lelo Marie-Pierre Hayette Paul Lusamba Dikassa Yasutoshi Kido Niko Speybroeck |
| author_sort | Nadine Kalenda Kayiba |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T17:01:10Z |
| format | Article |
| id | doaj.art-b21abea4264c4fdfb8ee8f3f224dcddc |
| institution | Directory Open Access Journal |
| issn | 1349-4147 |
| language | English |
| last_indexed | 2024-03-10T17:01:10Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Tropical Medicine and Health |
| spelling | doaj.art-b21abea4264c4fdfb8ee8f3f224dcddc2023-11-20T10:58:18ZengBMCTropical Medicine and Health1349-41472023-11-0151111610.1186/s41182-023-00551-7The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic reviewNadine Kalenda Kayiba0Evariste Tshibangu-Kabamba1Angel Rosas-Aguirre2Natsuko Kaku3Yu Nakagama4Akira Kaneko5Dieudonné Mvumbi Makaba6Doudou Yobi Malekita7Brecht Devleesschauwer8Joris Losimba Likwela9Pius Kabututu Zakayi10Patrick DeMol11Georges Mvumbi Lelo12Marie-Pierre Hayette13Paul Lusamba Dikassa14Yasutoshi Kido15Niko Speybroeck16Research Institute of Health and Society, Université Catholique de LouvainResearch Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan UniversityResearch Institute of Health and Society, Université Catholique de LouvainResearch Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan UniversityResearch Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan UniversityResearch Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan UniversityDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaDepartment of Epidemiology and Public Health, SciensanoDepartment of Public Health, Faculty of Medicine, University of KisanganiDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaLaboratory of Clinical Microbiology, Center for Interdisciplinary Research on Medicines, University of LiègeDepartment of Basic Sciences, Faculty of Medicine, University of KinshasaLaboratory of Clinical Microbiology, Center for Interdisciplinary Research on Medicines, University of LiègeSchool of Public Health, Faculty of Medicine, University of KinshasaResearch Center for Infectious Disease Science & Department of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan UniversityResearch Institute of Health and Society, Université Catholique de LouvainAbstract 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.https://doi.org/10.1186/s41182-023-00551-7Democratic Republic of CongoMalariaAntimalarial drug resistanceMutationsMolecular markers of drug resistance |
| spellingShingle | Nadine Kalenda Kayiba Evariste Tshibangu-Kabamba Angel Rosas-Aguirre Natsuko Kaku Yu Nakagama Akira Kaneko Dieudonné Mvumbi Makaba Doudou Yobi Malekita Brecht Devleesschauwer Joris Losimba Likwela Pius Kabututu Zakayi Patrick DeMol Georges Mvumbi Lelo Marie-Pierre Hayette Paul Lusamba Dikassa Yasutoshi Kido Niko Speybroeck The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review Tropical Medicine and Health Democratic Republic of Congo Malaria Antimalarial drug resistance Mutations Molecular markers of drug resistance |
| title | The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review |
| title_full | The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review |
| title_fullStr | The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review |
| title_full_unstemmed | The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review |
| title_short | The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review |
| title_sort | landscape of drug resistance in plasmodium falciparum malaria in the democratic republic of congo a mapping systematic review |
| topic | Democratic Republic of Congo Malaria Antimalarial drug resistance Mutations Molecular markers of drug resistance |
| url | https://doi.org/10.1186/s41182-023-00551-7 |
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