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

Abstract Background 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. Methods 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. Results 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. Conclusions 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.

Download Full-text

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

10.21203/rs.2.11285/v2 ◽

2019 ◽

Author(s):

Molly N/A Deutsch-Feldman ◽

Ozkan Aydemir ◽

Margaret Carrel ◽

Nicholas F. Brazeau ◽

Samir Bhatt ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Chloroquine Resistance ◽

Molecular Surveillance ◽

Mixed Effects Modeling ◽

Republic Of The Congo ◽

Temporal Model ◽

Wide Population ◽

Representative Samples

Abstract Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Download Full-text

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

10.21203/rs.2.11285/v1 ◽

2019 ◽

Author(s):

Molly Deutsch-Feldman ◽

Ozkan Aydemir ◽

Margaret Carrel ◽

Nicholas F. Brazeau ◽

Samir Bhatt ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Chloroquine Resistance ◽

Molecular Surveillance ◽

Mixed Effects Modeling ◽

Republic Of The Congo ◽

Temporal Model ◽

Wide Population ◽

Representative Samples

Abstract Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Download Full-text

Molecular surveillance of Plasmodium falciparum resistance to artemisinin-based combination therapies in the Democratic Republic of Congo

PLoS ONE ◽

10.1371/journal.pone.0179142 ◽

2017 ◽

Vol 12 (6) ◽

pp. e0179142 ◽

Cited By ~ 13

Author(s):

Dieudonné Makaba Mvumbi ◽

Thierry Lengu Bobanga ◽

Jean-Marie Ntumba Kayembe ◽

Georges Lelo Mvumbi ◽

Hippolyte Nani-Tuma Situakibanza ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Combination Therapies ◽

Molecular Surveillance ◽

Republic Of Congo

Download Full-text

Household prevalence of P. falciparum, P. vivax, and P. ovale in the Democratic Republic of the Congo, 2013-2014

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1772 ◽

2020 ◽

Author(s):

Cedar L Mitchell ◽

Hillary M Topazian ◽

Nicholas F Brazeau ◽

Molly Deutsch-Feldman ◽

Jeremie Muwonga ◽

...

Keyword(s):

Risk Factors ◽

Plasmodium Falciparum ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Molecular Study ◽

Age Group ◽

Cross Sectional ◽

Republic Of Congo ◽

Republic Of The Congo

Abstract In a cross-sectional molecular study in the Democratic Republic of Congo, 78% of households had at least one member infected with Plasmodium falciparum, vivax, and/or ovale spp. 47% of children and 33% of adults tested positive for at least one species. Risk factors varied by species and age group.

Download Full-text

Operation “Artemis”: The First Autonomous EU-led Operation

Academic and Applied Research in Military and Public ◽

10.32565/aarms.2015.1.11 ◽

2015 ◽

Vol 14 (1) ◽

pp. 121-132

Author(s):

János Tomolya

Keyword(s):

United Nations ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

European Security ◽

Republic Of Congo ◽

Autonomous Operation ◽

Republic Of The Congo ◽

Operational Constraints ◽

And Control ◽

The Eu

In June 2003, the EU launched Operation “Artemis”, its first military mission outside Europe and independent of NATO, to the Democratic Republic of Congo. While it ultimately received an EU badge, its origin, command and control were French. The objective of Operation “Artemis” was to contribute to the stabilisation of the security conditions in Bunia, capital of Ituri, to improve the humanitarian situation, and to ensure the protection of displaced persons in the refugee camps in Bunia. Its mandate was to provide a short-term interim force for three months until the transition to the reinforced United Nations Mission in the Democratic Republic of Congo (MONUC – Mission de l’Organisation des Nations Unies en République Démocratique du Congo; English: United Nations Organization Stabilization Mission in the Democratic Republic of the Congo). Although the EU can be said to have passed the first “test” of the European Security and Defence Policy (ESDP) mechanisms for the conduct of an autonomous operation, this test was a limited one. Operational constraints were caused by inadequate strategic lift capabilities and the lack of a strategic reserve.

Download Full-text

Who is Responsible for Instability in the Democratic Republic of Congo?

MGIMO Review of International Relations ◽

10.24833/2071-8160-2014-6-39-29-36 ◽

2014 ◽

pp. 29-36

Author(s):

G. M. Sidorova

Keyword(s):

Natural Resources ◽

Democratic Republic ◽

Central Government ◽

Democratic Republic Of Congo ◽

Raw Material ◽

Political Crisis ◽

Armed Groups ◽

Long Time ◽

The Usa ◽

Republic Of The Congo

The research focuses on the problem of military-political instability in the Democratic Republic of the Congo experiencing continued armed conflict for a long time. Dozens of illegal armed groups both Congolese and foreign origin continue to destabilize situation in the eastern part of the country causing humanitarian disasters. Due to governmental weakness, economic backwardness, chronical lack of finance resources, interethnic conflicts, all-round and widely spread corruption of the authorities, the Congolese government at the moment is not able to overcome scores of problems including the problem of security. Assistanceprovided to the DRC by itspartnerssuch as, first of all, the former metropolitan country Belgium, as well as the USA, Great Britain, the Europe Union and China works only in favourof these country-donors. They are attracted by rich Congolese natural resources which the DRC remaining one of the poorest countries in the world cannot turn to advantage to the full extent because of its economic backwardness. In exchange for so-calleddevelopment programmes, expensive strategic raw material (such as coltan, wolfram, casseterit, cooper, gold, niobium, and other) is being extracted and exported from the country, in addition, often on the inequivalent basis. This is taking place for the reason that numerous mines and open-cast mines are being controlled by different illegal armed groups and not by the central government. Therefore, it turns out that in the context of a military-political crisis, for so-called partners it is more beneficial to pursue their own interests. Furthermore, western ideologists arouse "separatism-oriented" theories similar to "balkanization", in other words, a breakdown of this giant country into several independent states. The Congolese are tremulous to this issue, they try to counter such approachs and defend the territorial integrity of the DRC. However, it is not an easy task. The impediment is unsettled relations with neighbouring countries - Rwanda, Uganda and Burundi which for tens of years exploit illegally natural resources of the DRC and try to lay hold of frontier Congolese territories.

Download Full-text

Assessing the efficacy of chloroquine and sulfadoxine-pyrimethamine for treatment of uncomplicated Plasmodium falciparum malaria in the Democratic Republic of Congo

Tropical Medicine & International Health ◽

10.1046/j.1365-3156.2003.01098.x ◽

2003 ◽

Vol 8 (10) ◽

pp. 868-875 ◽

Cited By ~ 16

Author(s):

Walter M. Kazadi ◽

Sirenda Vong ◽

Burstein N. Makina ◽

Jean C. Mantshumba ◽

Willy Kabuya ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Falciparum Malaria ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Plasmodium Falciparum Malaria ◽

Republic Of Congo ◽

Uncomplicated Plasmodium Falciparum Malaria

Download Full-text

Successes and Failures in Côte d’Ivoire and the Democratic Republic of Congo

Peacekeeping in the Midst of War ◽

10.1093/oso/9780198845577.003.0006 ◽

2019 ◽

pp. 132-168

Author(s):

Lisa Hultman ◽

Jacob D. Kathman ◽

Megan Shannon

Keyword(s):

Cote D'ivoire ◽

Côte D’Ivoire ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Relative Effectiveness ◽

Cote D’Ivoire ◽

Violence Reduction ◽

Côte D'ivoire ◽

Republic Of The Congo ◽

Peacekeeping Missions

This chapter explores two conflicts and their related UN missions: Côte d’Ivoire (UNOCI) and the Democratic Republic of the Congo (MONUC and MONUSCO). The chapter conducts qualitative analyses of these missions to explore the effect peacekeeping capacity and constitution on civil war violence, noting the UN’s ability to engage in mechanisms of violence reduction. The conflicts are not two cases of obvious peacekeeping success, and there are clear instances of failure in both UN efforts. However, in many situations, the missions were more effective when capacity and constitution improved, indicating that relative effectiveness increases as UN missions are sufficiently outfitted. The chapter complements the quantitative analyses by highlighting the limits of the theory and the challenges to peacekeeping missions in the midst of war.

Download Full-text