Assessment of Plasmodium falciparum anti-malarial drug resistance markers in pfk13-propeller, pfcrt and pfmdr1 genes in isolates from treatment failure patients in Democratic Republic of Congo, 2018–2019

Abstract Background The national policy for malaria treatment of the Democratic Republic Congo recommends two first-line artemisinin-based combinations uncomplicated malaria: artesunate-amodiaquine and artemether-lumefantrine. This study investigated presence markers associated with resistance to current combination therapy (ACT) in isolates Plasmodium falciparum from failure patients Congo. Methods From November 2018 2019, dried blood spots were taken returning health centres fever within 28 days after an initial six sentinel sites National Malaria Control Programme across new episode was first detected by a rapid diagnostic test then confirmed real-time PCR assay define failure. Fragments interest pfk13 pfcrt genes amplified conventional before sequencing Pfmdr1 gene copy number determined TaqMan assay. Results Out 474 enrolled patients, 364 (76.8%) positive P. malaria, thus considered as Of 325 obtained -positive successfully sequenced pfk13- propeller gene, 7 (2.2%) carried non-synonymous mutations, among which 3 have been previously reported (N498I, N554K A557S) 4 had not yet (F506L, E507V, D516E G538S). 335 139 (41.5%) harboured K76T mutation known be chloroquine resistance. SVMNT haplotype amodiaquine found. None increased pfmdr1 322 analysed. Conclusion No molecular currently ACT use patients. Regular monitoring through vivo drug efficacy studies must continue ensure effectiveness