Molecular surveillance of anti-malarial drug resistance in Democratic Republic of Congo: high variability of chloroquinoresistance and lack of amodiaquinoresistance
[en] Background: The loss of chloroquine (CQ) efectiveness has led to its withdrawal from national policies as a frst-line treatment for uncomplicated malaria in several endemic countries, such as the Democratic Republic of Congo (DRC). The K76T mutation on the pfcrt gene has been identifed as a marker of CQ resistance and the SVMNT haplotype in codons 72–76 on the same gene has been associated with resistance to amodiaquine (AQ). In the DRC, the prevalence of K76T has decreased from 100% in 2000 to 63.9% in 2014. The purpose of this study was to determine the prevalence of K76T mutations in circulating strains of Plasmodium falciparum, 16 years after CQ withdrawal in the DRC and to investigate the presence of the SVMNT haplotype.
Methods: In 2017, ten geographical sites across the DRC were selected. Dried blood samples were collected from patients attending health centres. Malaria was frst detected by a rapid diagnostic test (RDT) available on site (SD Bioline Malaria Ag Pf or CareStart Malaria Pf) or thick blood smear and then confrmed by a P. falciparum species-specifc real-time PCR assay. A pfcrt gene segment containing a fragment that encodes amino acids at positions 72–76 was amplifed by conventional PCR before sequencing.
Results: A total of 1070 patients were enrolled. Of the 806 PCR-confrmed P. falciparum positive samples, 764 were successfully sequenced. The K76T mutation was detected in 218 samples (28.5%; 95% CI 25.4%–31.9%), mainly (96%) with the CVIET haplotype. Prevalence of CQ resistance marker was unequally distributed across the country, ranging from 1.5% in Fungurume to 89.5% in Katana. The SVMNT haplotype, related to AQ resistance, was not detected.
Conclusion: Overall, the frequency of the P. falciparum CQ resistance marker has decreased signifcantly and no resistance marker to AQ was detected in the DRC in 2017. However, the between regions variability of CQ resistance remains high in the country. Further studies are needed for continuous monitoring of the CQ resistance level for its prospective re-use in malaria management. The absence of the AQ resistance marker is in line with the use of this drug in the current DRC malaria treatment policy.
Research center :
Laboratory of molecular biology and clinical microbiology (Uliège) and LBM UNIKIN
Disciplines :
Immunology & infectious disease Laboratory medicine & medical technology
Author, co-author :
Yobi, Doudou
Kayiba, Nadine
Mvumbi, Dieudonné
BOREUX, Raphaël ; Centre Hospitalier Universitaire de Liège - CHU > Unilab > Laboratoire biologie moléculaire
Kabututu, Pius
Situakibanza, Hippolyte
Likwela, Joris
De Mol, Patrick ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Département des sciences biomédicales et précliniques
Okitolonda, Emile
Niko, Speybroeck
Mvumbi, Georges
Hayette, Marie-Pierre ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie
Language :
English
Title :
Molecular surveillance of anti-malarial drug resistance in Democratic Republic of Congo: high variability of chloroquinoresistance and lack of amodiaquinoresistance
Alternative titles :
[fr] Surveillance moléculaire de la résistance antimalarique en RDC: grande variabilité de la chloroquinorésistance et absence de résistance à l'amodiaquine
Publication date :
March 2020
Journal title :
Malaria Journal
eISSN :
1475-2875
Publisher :
BioMed Central, United Kingdom
Volume :
19
Issue :
121
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
ARES - Académie de Recherche et d'Enseignement Supérieur [BE]
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