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@article{van:2019:10.1186/s12936-019-3057-7,
author = {van, Lenthe M and van, der Meulen R and Lassovski, M and Ouabo, A and Bakula, E and Badio, C and Cibenda, D and Okell, L and Piriou, E and Grignard, L and Lanke, K and Rao, B and Bousema, T and Roper, C},
doi = {10.1186/s12936-019-3057-7},
journal = {Malaria Journal},
pages = {1--9},
title = {Markers of sulfadoxine-pyrimethamine resistance in Eastern Democratic Republic of Congo; implications for malaria chemoprevention},
url = {http://dx.doi.org/10.1186/s12936-019-3057-7},
volume = {18},
year = {2019}
}

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TY  - JOUR
AB  - BackgroundSulfadoxine–pyrimethamine (SP) is a cornerstone of malaria chemoprophylaxis and is considered for programmes in the Democratic Republic of Congo (DRC). However, SP efficacy is threatened by drug resistance, that is conferred by mutations in the dhfr and dhps genes. The World Health Organization has specified that intermittent preventive treatment for infants (IPTi) with SP should be implemented only if the prevalence of the dhps K540E mutation is under 50%. There are limited current data on the prevalence of resistance-conferring mutations available from Eastern DRC. The current study aimed to address this knowledge gap.MethodsDried blood-spot samples were collected from clinically suspected malaria patients [outpatient department (OPD)] and pregnant women attending antenatal care (ANC) in four sites in North and South Kivu, DRC. Quantitative PCR (qPCR) was performed on samples from individuals with positive and with negative rapid diagnostic test (RDT) results. Dhps K450E and A581G and dhfr I164L were assessed by nested PCR followed by allele-specific primer extension and detection by multiplex bead-based assays.ResultsAcross populations, Plasmodium falciparum parasite prevalence was 47.9% (1160/2421) by RDT and 71.7 (1763/2421) by qPCR. Median parasite density measured by qPCR in RDT-negative qPCR-positive samples was very low with a median of 2.3 parasites/µL (IQR 0.5–25.2). Resistance genotyping was successfully performed in RDT-positive samples and RDT-negative/qPCR-positive samples with success rates of 86.2% (937/1086) and 55.5% (361/651), respectively. The presence of dhps K540E was high across sites (50.3–87.9%), with strong evidence for differences between sites (p < 0.001). Dhps A581G mutants were less prevalent (12.7–47.2%). The dhfr I164L mutation was found in one sample.ConclusionsThe prevalence of the SP resistance marker dhps K540E exceeds 50% in all four study sites in North and South Kivu, DR
AU  - van,Lenthe M
AU  - van,der Meulen R
AU  - Lassovski,M
AU  - Ouabo,A
AU  - Bakula,E
AU  - Badio,C
AU  - Cibenda,D
AU  - Okell,L
AU  - Piriou,E
AU  - Grignard,L
AU  - Lanke,K
AU  - Rao,B
AU  - Bousema,T
AU  - Roper,C
DO  - 10.1186/s12936-019-3057-7
EP  - 9
PY  - 2019///
SN  - 1475-2875
SP  - 1
TI  - Markers of sulfadoxine-pyrimethamine resistance in Eastern Democratic Republic of Congo; implications for malaria chemoprevention
T2  - Malaria Journal
UR  - http://dx.doi.org/10.1186/s12936-019-3057-7
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000506910700005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://malariajournal.biomedcentral.com/articles/10.1186/s12936-019-3057-7
UR  - http://hdl.handle.net/10044/1/77328
VL  - 18
ER  -

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