The changing landscape of Plasmodium falciparum drug resistance in the Democratic Republic of Congo

Molly Deutsch-Feldman; Ozkan Aydemir; Margaret Carrel; Nicholas F Brazeau; Samir Bhatt; Jeffrey A Bailey; Melchior Kashamuka; Antoinette K Tshefu; Steve M Taylor; Jonathan J Juliano; Steven R Meshnick; Robert Verity

doi:10.1186/s12879-019-4523-0

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The changing landscape of Plasmodium falciparum drug resistance in the Democratic Republic of Congo

Journal article

Open access

Peer reviewed

The changing landscape of Plasmodium falciparum drug resistance in the Democratic Republic of Congo

Molly Deutsch-Feldman, Ozkan Aydemir, Margaret Carrel, Nicholas F Brazeau, Samir Bhatt, Jeffrey A Bailey, Melchior Kashamuka, Antoinette K Tshefu, Steve M Taylor, Jonathan J Juliano, …

BMC infectious diseases, Vol.19(1), pp.872-872

10/22/2019

DOI: 10.1186/s12879-019-4523-0

PMCID: PMC6805465

PMID: 31640574

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Abstract

Drug resistant malaria is a growing concern in the Democratic Republic of the Congo (DRC), where previous studies indicate that parasites resistant to sulfadoxine/pyrimethamine or chloroquine are spatially clustered. This study explores longitudinal changes in spatial patterns to understand how resistant malaria may be spreading within the DRC, using samples from nation-wide population-representative surveys. We selected 552 children with PCR-detectable Plasmodium falciparum infection and identified known variants in the pfdhps and pfcrt genes associated with resistance. We compared the proportion of mutant parasites in 2013 to those previously reported from adults in 2007, and identified risk factors for carrying a resistant allele using multivariate mixed-effects modeling. Finally, we fit a spatial-temporal model to the observed data, providing smooth allele frequency estimates over space and time. The proportion of co-occurring pfdhps K540E/A581G mutations increased by 16% between 2007 and 2013. The spatial-temporal model suggests that the spatial range of the pfdhps double mutants expanded over time, while the prevalence and range of pfcrt mutations remained steady. This study uses population-representative samples to describe the changing landscape of SP resistance within the DRC, and the persistence of chloroquine resistance. Vigilant molecular surveillance is critical for controlling the spread of resistance.

Adolescent

Adult

Alcohol Dehydrogenase - genetics

Antimalarials - therapeutic use

Chloroquine - therapeutic use

Cross-Sectional Studies

Democratic Republic of the Congo - epidemiology

Drug Combinations

Drug Resistance - drug effects

Drug Resistance - genetics

Gene Frequency

Humans

Longitudinal Studies

Malaria, Falciparum - drug therapy

Malaria, Falciparum - epidemiology

Malaria, Falciparum - parasitology

Membrane Transport Proteins - genetics

Middle Aged

Mutation

Plasmodium falciparum - drug effects

Plasmodium falciparum - genetics

Prevalence

Protozoan Proteins - genetics

Pyrimethamine - therapeutic use

Spatio-Temporal Analysis

Sulfadoxine - therapeutic use

Young Adult

Details

Title: Subtitle: The changing landscape of Plasmodium falciparum drug resistance in the Democratic Republic of Congo
Creators: Molly Deutsch-Feldman - University of North Carolina at Chapel Hill
Ozkan Aydemir - Brown University
Margaret Carrel - University of Iowa
Nicholas F Brazeau - University of North Carolina at Chapel Hill
Samir Bhatt - Imperial College London
Jeffrey A Bailey - Brown University
Melchior Kashamuka - University of Kinshasa
Antoinette K Tshefu - University of Kinshasa
Steve M Taylor - Duke University
Jonathan J Juliano - University of North Carolina at Chapel Hill
Steven R Meshnick - University of North Carolina at Chapel Hill
Robert Verity - Imperial College London
Resource Type: Journal article
Publication Details: BMC infectious diseases, Vol.19(1), pp.872-872
DOI: 10.1186/s12879-019-4523-0
PMID: 31640574
PMCID: PMC6805465
NLM abbreviation: BMC Infect Dis
ISSN: 1471-2334
eISSN: 1471-2334
Grant note: R01AI139520 / Foundation for the National Institutes of Health R01AI107949 / Foundation for the National Institutes of Health F30 AI143172 / NIAID NIH HHS NA / European and Developing Countries Clinical Trials Partnership K24AI134990 / Foundation for the National Institutes of Health R21AI121465 / Foundation for the National Institutes of Health R01 AI139520 / NIAID NIH HHS K24 AI134990 / NIAID NIH HHS MR/R015600/1 / Medical Research Council MR/N01507X/1 / Medical Research Council NA / Medical Research Council
Language: English
Date published: 10/22/2019
Academic Unit: Epidemiology; Interdisciplinary Programs; Geographical and Sustainability Sciences; Internal Medicine
Record Identifier: 9984259634302771

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