Close Proximity to Mining Is Associated with Increased Prevalence of the Drug Resistance-Associated Mutation dhps540E in Eastern Democratic Republic of the Congo

Am J Trop Med Hyg. 2024 Jun 11;111(2):361-364. doi: 10.4269/ajtmh.23-0355. Print 2024 Aug 7.

Abstract

Increasing sulfadoxine-pyrimethamine (SP) resistance in the Democratic Republic of the Congo (DRC) has threatened its use for prevention of malaria in one of the most malarious countries in the world. Using geographic information on mining operations in the DRC and genetic data on SP drug resistance markers from the 2013-2014 Demographic and Health Surveys, we evaluated associations between close residence to mining and the presence of mutations conferring resistance to sulfadoxine. Close residential proximity to mining was associated with increased prevalence odds ratio (POR) of the dhps540E mutation (POR: 2.11, 95% uncertainty interval: 1.15-3.96) with adjustments for confounding variables and space. Our findings indicate that exposure to mining is associated with increased presence of an antimalarial drug resistance haplotype that threatens effective use of SP for vulnerable populations. Areas actively engaged in mining could be considered for interventions to reduce the spread of emerging drug resistance in the DRC.

MeSH terms

  • Antimalarials* / pharmacology
  • Antimalarials* / therapeutic use
  • Democratic Republic of the Congo / epidemiology
  • Dihydropteroate Synthase / genetics
  • Drug Combinations
  • Drug Resistance* / genetics
  • Female
  • Humans
  • Malaria, Falciparum / epidemiology
  • Malaria, Falciparum / parasitology
  • Mining*
  • Mutation*
  • Plasmodium falciparum / drug effects
  • Plasmodium falciparum / genetics
  • Prevalence
  • Pyrimethamine* / pharmacology
  • Pyrimethamine* / therapeutic use
  • Sulfadoxine* / pharmacology
  • Sulfadoxine* / therapeutic use

Substances

  • Antimalarials
  • Pyrimethamine
  • Sulfadoxine
  • Dihydropteroate Synthase
  • fanasil, pyrimethamine drug combination
  • Drug Combinations