article · PLoS ONE
Malaria remains a major public health challenge in the Democratic Republic of Congo, requiring vigilant surveillance of Plasmodium falciparum strains. Genetic variations in the pfcrt, pfmdr1, and pfk13 genes were assessed to monitor possible resistance against amodiaquine, lumefantrine, and artemisinin. The investigation demonstrated that chloroquine resistance continues to decline and markers for amodiaquine resistance appear absent. Pfmdr1 amplification was identified in three samples collected from the eastern region. Crucially, established mutations linked to artemisinin resistance in South-East Asia were not present. Nevertheless, novel mutations emerged, notably M476K at the identical locus to a known resistance mutation in the F32-ART strain. Overall, first-line artemisinin-based combination therapies currently deployed across the Democratic Republic of Congo do not show an association with emerging resistance markers.
Artemisinin-based combination therapies are the primary defence against malaria. Monitoring whether parasites are mutating to survive these medicines helps health authorities evaluate treatment efficacy. Confirming that standard first-line therapies remain effective provides vital reassurance for national treatment guidelines, while identifying novel mutations allows public health programmes to track potential threats before resistance becomes widespread.
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Malaria is a major public health problem in the Democratic Republic of Congo. Despite progress achieved over the past decade in the fight against malaria, further efforts have to be done such as in the surveillance and the containment of Plasmodium falciparum resistant strains. We investigated resistance to artemisinin-based combination therapies currently in use in Democratic Republic of Congo by surveying molecular polymorphisms in three genes: pfcrt, pfmdr1 and pfk13 to explore possible emergence of amodiaquine, lumefantrine or artemisinin resistance in Democratic Republic of Congo. This study essentially revealed that resistance to chloroquine is still decreasing while polymorphism related to amodiaquine resistance seems to be not present in Democratic Republic of Congo, that three samples, located in the east of the country, harbor Pfmdr1 amplification and that none of the mutations found in South-East Asia correlated with artemisinine resistance have been found in Democratic Republic of Congo. But new mutations have been identified, especially the M476K, occurred in the same position that the M476I previously identified in the F32-ART strain, strongly resistant to artemisinine. Antimalarial first-line treatments currently in use in Democratic Republic of Congo are not associated with emergence of molecular markers of resistance.
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DOI: 10.1371/journal.pone.0179142
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