scholarly journals Therapeutic Efficacy of Artemisinin-Based Combination Therapies in Democratic Republic of the Congo and Investigation of Molecular Markers of Antimalarial Resistance

2021 ◽  
Author(s):  
Leah F. Moriarty ◽  
Papy Mandoko Nkoli ◽  
Joris Losimba Likwela ◽  
Patrick Mitashi Mulopo ◽  
Eric Mukomena Sompwe ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Therapeutic Efficacy ◽  
Democratic Republic ◽  
Monitoring Site ◽  
Combination Therapies ◽  
Primary Endpoints ◽  
Antimalarial Resistance ◽  
Republic Of The Congo ◽  
Polymerase Chain ◽  
Routine Assessment

Routine assessment of the efficacy of artemisinin-based combination therapies (ACTs) is critical for the early detection of antimalarial resistance. We evaluated the efficacy of ACTs recommended for treatment of uncomplicated malaria in five sites in Democratic Republic of the Congo (DRC): artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), and dihydroartemisinin-piperaquine (DP). Children aged 6–59 months with confirmed Plasmodium falciparum malaria were treated with one of the three ACTs and monitored. The primary endpoints were uncorrected and polymerase chain reaction (PCR)-corrected 28-day (AL and ASAQ) or 42-day (DP) cumulative efficacy. Molecular markers of resistance were investigated. Across the sites, uncorrected efficacy estimates ranged from 63% to 88% for AL, 73% to 100% for ASAQ, and 56% to 91% for DP. PCR-corrected efficacy estimates ranged from 86% to 98% for AL, 91% to 100% for ASAQ, and 84% to 100% for DP. No pfk13 mutations previously found to be associated with ACT resistance were observed. Statistically significant associations were found between certain pfmdr1 and pfcrt genotypes and treatment outcome. There is evidence of efficacy below the 90% cutoff recommended by WHO to consider a change in first-line treatment recommendations of two ACTs in one site not far from a monitoring site in Angola that has shown similar reduced efficacy for AL. Confirmation of these findings in future therapeutic efficacy monitoring in DRC is warranted.

scholarly journals Clinical Efficacy of Artemether-Lumefantrine in Congolese Children with Acute Uncomplicated Falciparum Malaria in Brazzaville

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Mathieu Ndounga ◽  
Rachida Tahar ◽  
Prisca N. Casimiro ◽  
Dieudonné Loumouamou ◽  
Leonardo K. Basco
Keyword(s):  
Capital City ◽  
World Health ◽  
Combination Therapies ◽  
Cure Rate ◽  
First Line ◽  
Republic Of The Congo ◽  
Polymerase Chain ◽  
The Republic ◽  
Health Organization ◽  
World Health Organization Guideline

The Republic of the Congo adopted artemisinin-based combination therapies (ACTs) in 2006: artesunate-amodiaquine and artemether-lumefantrine as the first-line and second-line drugs, respectively. The baseline efficacy of artemether-lumefantrine was evaluated between March and July 2006 in Brazzaville, the capital city of Congo. Seventy-seven children aged between 6 months and 10 years were enrolled in a nonrandomized study. The children were treated under supervision with 6 doses of artemether-lumefantrine and followed up for 28 days in accordance with the 2003 World Health Organization guideline. Pretreatment (i.e., day 0) and recrudescent Plasmodium falciparum isolates between day 14 and day 28 were compared by the polymerase chain reaction to distinguish between true recrudescence and reinfection. The overall cure rate on day 28 was 96.9% after PCR correction. Reported adverse effects included pruritus and dizziness. Artemether-lumefantrine was highly efficacious in Brazzaville.

scholarly journals The Burden of Malaria in the Democratic Republic of the Congo

2020 ◽  
Author(s):  
Molly Deutsch-Feldman ◽  
Jonathan B Parr ◽  
Corinna Keeler ◽  
Nicholas F Brazeau ◽  
Varun Goel ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Linear Models ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Malaria Prevalence ◽  
Older Children ◽  
Chain Reaction ◽  
Republic Of The Congo ◽  
Polymerase Chain ◽  
Polymerase Chain Reaction Data

Abstract Despite evidence that older children and adolescents bear the highest burden of malaria, large malaria surveys focus on younger children. We used polymerase chain reaction data from the 2013–2014 Demographic and Health Survey in the Democratic Republic of Congo (including children aged <5 years and adults aged ≥15 years) and a longitudinal study in Kinshasa Province (participants aged 6 months to 98 years) to estimate malaria prevalence across age strata. We fit linear models and estimated prevalences for each age category; adolescents aged 10–14 years had the highest prevalence. We estimate approximately 26 million polymerase chain reaction–detectable infections nationally. Adolescents and older children should be included in surveillance studies.

Constitutional Incorporation of the (Collective) Freedom to Govern Mineral Wealth: Comparing the Democratic Republic of the Congo and the Republic of Zambia

2020 ◽  
Vol 28 (1) ◽  
pp. 1-29
Author(s):  
Alexandra Carleton
Keyword(s):  
Natural Resources ◽  
Democratic Republic ◽  
Mineral Wealth ◽  
The People ◽  
Republic Of The Congo ◽  
The Republic

Constitutionalism may be gaining ascendancy in many countries in Africa. Yet thorough investigation of the extent to which current constitutions accord to the people their internationally recognised right to governance of their mineral wealth under Article 1(2) of the ICCPR has been lacking. Understanding the existing framework of rights which may support claims to land and natural resources is important. Constitutions of the Democratic Republic of the Congo and the Republic of Zambia demonstrate the reality of multiple, overlapping land interests and the limitations upon a people's claim to freely govern their mineral wealth.

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