Characterization of the antimalarial drug resistance landscape in Kinshasa Province, Democratic Republic of the Congo

Malaria is the leading cause of morbidity and mortality in the Democratic Republic of the Congo (DRC), which bears the second largest burden of malaria and accounted for 13% of global malaria deaths in 2021. Effective treatment is an essential component of malaria case management. Artemisinin-based combination therapies (ACTs) are the current first-line and most effective antimalarial treatment. Reports of resistance to ACTs in neighboring Rwanda, Tanzania, and Uganda raise concerns about the future of malaria control in the DRC and across sub-Saharan Africa. Moreover, few studies have investigated the role of overtreatment of individuals with false-positive rapid diagnostic test results and how it modifies the selective pressure of artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL), two first-line ACTs in the DRC. Improved understanding of the extent and drivers of drug resistance and of the influence of malaria misdiagnosis on selective drug pressure is imperative to inform ongoing malaria control efforts in the DRC and similar high-burden countries. This proposal uses data and samples collected during a 2015-2022 malaria longitudinal cohort study of children and adults in areas of varying endemicities in Kinshasa Province, DRC. This project will leverage this well-characterized cohort as well as the two-decade of strong research collaboration between the University of North Carolina at Chapel Hill and partner institutions in Kinshasa. Through this research proposal and tailored training plan, the trainee will achieve the following fellowship goals: 1) acquire advanced skills in epidemiological and statistical methods, molecular and spatial epidemiology applied to infectious diseases; 2) pursue clinical training at the intersection of infectious diseases and other areas of medicine to inform my choice of residency; and 3) hone the professional skills needed to succeed as a physician- scientist and navigate international collaborations.

Project details

Drug Resistance

Apr 2024 — Mar 2029

$42,232

Dem. Rep. of Congo