Genomic profiling of drug resistance markers in Plasmodium falciparum samples from the Democratic Republic of the Congo (2017) and Tanzania (2020-2021).

Authors

Flory Luzolo Khote, Hypolite Muhindo Mavoko, Patrick Mitashi, Papy Mandoko, Destin Mbongi, Geofrey Makenga, Daniel T R Minja, Filbert Francis, Reginald Kavishe, Jean-Pierre van Geertruyden, Gauthier Mesia Kahunu, Didier Menard, Vito Baraka

Published in

The Journal of antimicrobial chemotherapy. Volume 81. Issue 10. Sep 01, 2026.

Abstract

Molecular surveillance is essential to detect emerging artemisinin partial resistance (ART-R) and partner drug resistance in Sub-Saharan Africa.
To describe the prevalence of Plasmodium falciparum resistance markers in two high-burden countries using artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL): the Democratic Republic of the Congo (DRC) and Tanzania.
A total of 1254 day-0 P. falciparum-positive samples were analysed: 837 from four sentinel sites of a therapeutic efficacy study (TES) in the DRC (2017) and 417 from an intermittent preventive treatment in schoolchildren (IPTsc) trial in Handeni and Kilindi districts, Tanga Region, Tanzania (2020-2021). Pfkelch13, Pfcrt and Pfmdr1 were analysed by Illumina MiSeq amplicon sequencing.
Reliable sequences were obtained for 1193 isolates. The Pfkelch13 wild-type allele predominated (98.4%); none of the four non-synonymous mutations detected (N489Y, K568T, A578S, V589I) are classified as validated, candidate or potential ART-R markers, and the validated markers R561H, P441L and C469Y reported elsewhere in East Africa were absent. Pfcrt K76T was found in 23.3% of Tanzanian and 26.3% of DRC isolates, with substantial between-site variation in the DRC (4.3% to 93.6% at Rutshuru). Pfmdr1 haplotype profiles differed between countries: NFSND predominated in Tanzania (71.5%) while NYSND remained the most frequent in the DRC (60.9%); 86Y was twice as frequent in the DRC (11.1%) as in Tanzania (6.2%).
No validated ART-R marker was detected, but partner-drug haplotype distributions reflected the first-line ACTs used in each country. Continued molecular surveillance is needed to track these signatures alongside the recent emergence of ART-R.

PMID:
42678034
Bibliographic data and abstract were imported from PubMed on 01 Sep 2026.

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