Molecular identification of sulfadoxine-pyrimethamine resistance in malaria infected women who received intermittent preventive treatment in the Democratic Republic of Congo

Background: The consequences of malaria during pregnancy are different regarding local conditions of malaria transmission. In stable malaria areas, the main complications are maternal anaemia and fetal growth restriction. This study aims to determine if pregnancy-associated malaria is associated with the risk of the above-mentioned complications and to determine if IPTp-sp reduces them in Kisangani. Methods: It is a cross-sectional analytical study conducted in parturients, in 6 medical facilities of Kisangani, from January 1st to September 30th, 2017. At delivery we measured their hemoglobin, we performed the thick blood smear of their peripheral blood and placental apposition; and we weighed their newborns at birth. Results: Risk of anaemia at delivery increased with malaria access during pregnancy (p = 0.0056; OR: 1.4221, 95% CI: 1.0851-1.8638) and peripheral parasitaemia at delivery (p = 0.0000; OR: 6.3855, 95% CI: 4.5552-8.9512). LBW increased with peripheral parasitaemia at delivery (p = 0.0000; OR: 3.5299, 95% CI: 2.4424-5.1015) and placental parasitaemia (p = 0.0000; OR: 18.3247, 95% CI: 12.5141-26.8332). IPTp-sp did not have effect on maternal hemoglobin at delivery (p = 0.1546; OR: 0.7553, IC à 95%: 0.4414-1.2923) and the birth weight (p = 0.1225; OR: 0.6638, IC à 95%: 0.3375-1.3056). Conclusion: In Kisangani, pregnancy-associated malaria is associated with maternal anaemia at delivery and LBW. IPTp-sp does not reduce the risk of these complications.

show abstract

“…Our results would be due to the resistance of parasites to SP; indeed, cases of resistance to SP have been reported in DRC [34].…”

Section: Effect Of Iptp-sp On Maternal Hemoglobin At Delivery and Birsupporting

confidence: 52%

Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine Does Not Have Effect on Maternal Hemoglobin at Delivery and Birth Weight in Kisangani, Democratic Republic of Congo

Noël¹,

Jean-Didier²,

Mike-Antoine³

et al. 2019

JBM

View full text Add to dashboard Cite

show abstract

“…Taking IPTp-sp had no effect on congenital malaria and low birth weight because of the resistance of plasmodium to Sulfadoxine-Pyrimethamine, reported in DRC [27]. It was reported in a study conducted in Kisangani that IPTp-sp did not have an effect on the birth weight [28].…”

Section: Relationship Between Taking Iptp-sp and The Outcome Ofmentioning

confidence: 99%

Prevalence of Congenital Malaria in Kisangani, A Stable Malaria Transmission Area in Democratic Republic of the Congo

Noël

Jean-Didier

Mike-Antoine

et al. 2020

Infectious Diseases in Obstetrics and Gynecology

View full text Add to dashboard Cite

Background. Gestational malaria is a major public health problem. It produces fetal complications such as low birth weight, perinatal mortality, and congenital malaria. The present study is aimed at determining the prevalence of congenital malaria and its neonatal complications in the city of Kisangani. Methods. We conducted a cross-sectional study in Kisangani from 1 January to 30 September 2018. Our study population was composed of 1248 newborns born in our study sites, during the period of our study. Just after their birth, we performed the thick drop smear in the placental print and in umbilical blood smear. Results. The prevalence of congenital malaria was 13.98%; 69.23% of newborns who contracted congenital malaria were from 18- to 34-year-old mothers, 53.85% from primiparous mothers, 92.31% from mothers who took intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine, all (100%) from mothers using the insecticide-treated mosquito nets and 7.69% from HIV-positive mothers. Low birth weight and perinatal mortality were recorded in 76.92% and 7.69% of congenital malaria cases, respectively. Intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine had no effect on congenital malaria (FE=0.5218; OR: 0.8, 95% CI: 0.1651-3.8769) and on low birth weight (FE=0.3675; OR: 1.2308, 95% CI: 0.0037-0.1464); however, it seemed to have protective effect against perinatal mortality (FE=0.0001; OR: 0.0233, 95% CI: 0.0037-0.1464). Conclusion. Congenital malaria remains a major problem in stable malaria transmission area like Kisangani, and it is grafted by major perinatal complications, particularly low birth weight and perinatal mortality. We recommend an extended study to clarify the relationship between the outcome of pregnancy and the intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine.

show abstract

“…Chloroquine resistance has remained relatively steady since 2007; the proportion of CVIET parasites is unchanged and the spatial distribution remains similar. These findings are troubling as the DRC halted chloroquine use as a first line treatment in 2001 due to concerns about growing resistance (47,48).…”

Section: Spatial-temporal Prediction Mapsmentioning

confidence: 99%

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

Deutsch-Feldman

Aydemir

Carrel

et al. 2019

Preprint

View full text Add to dashboard Cite

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.

show abstract

Molecular identification of sulfadoxine-pyrimethamine resistance in malaria infected women who received intermittent preventive treatment in the Democratic Republic of Congo

Cited by 26 publications

References 15 publications

Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine Does Not Have Effect on Maternal Hemoglobin at Delivery and Birth Weight in Kisangani, Democratic Republic of Congo

Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine Does Not Have Effect on Maternal Hemoglobin at Delivery and Birth Weight in Kisangani, Democratic Republic of Congo

Prevalence of Congenital Malaria in Kisangani, A Stable Malaria Transmission Area in Democratic Republic of the Congo

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

Contact Info

Product

Resources

About