Falciparum malaria molecular drug resistance in the Democratic Republic of Congo: a systematic review

Background: Malaria cases were estimated to 207 million in 2013. One of the problems of malaria control is the
emergence and spread of Plasmodium falciparum strains that become resistant to almost all drugs available. Monitoring
drug resistance is essential for early detection and subsequent prevention of the spread of drug resistance by
timely changes of treatment policy. This review was performed to gather all data available on P. falciparum molecular
resistance in DR Congo, as baseline for future assessments.
Methods: The search for this review was undertaken using the electronic databases PubMed and Google Scholar
using the terms “malaria”, “Congo”, “resistance”, “molecular”, “antimalarial”, “efficacy”. Articles were classified based on year
of collecting, year of publication, sample size and characteristics, molecular markers analysed and polymorphisms
detected.
Results: Thirteen articles were included and five genes have been analysed in these studies: pfcrt, pfdhps, pfdhfr,
pfmdr1 and K13-propeller. The majority of studies included were not representative of the whole country.
Conclusion: This systematic review demonstrates the lack of molecular resistance studies in DRC. Only 13 studies
were identified in almost 15 years. The MOH must implement a national surveillance system for monitoring malaria
drug resistance and this surveillance should be conducted frequently and country-representative.