Varied Prevalence of Antimalarial Drug Resistance Markers in Different Populations of Newly Arrived Refugees in Uganda

Author:

Tukwasibwe Stephen123ORCID,Garg Shreeya4,Katairo Thomas2,Asua Victor2ORCID,Kagurusi Brian A2,Mboowa Gerald56ORCID,Crudale Rebecca7,Tumusiime Gerald3,Businge Julius8,Alula David8,Kasozi Julius9,Wadembere Ibrahim9,Ssewanyana Isaac2,Arinaitwe Emmanuel2,Nankabirwa Joaniter I12,Nsobya Samuel L2,Kamya Moses R12,Greenhouse Bryan4,Dorsey Grant4,Bailey Jeffrey A7ORCID,Briggs Jessica4ORCID,Conrad Melissa D4,Rosenthal Philip J4

Affiliation:

1. Makerere University , Kampala , Uganda

2. Infectious Diseases Research Collaboration , Kampala , Uganda

3. Uganda Christian University , Mukono , Uganda

4. Department of Medicine, University of California, San Francisco , San Francisco, California , USA

5. Infectious Diseases Institute , Kampala , Uganda

6. Africa Centers for Disease Control and Prevention , Addis Ababa , Ethiopia

7. Brown University , Providence, Rhode Island , USA

8. Medical Teams International , Kampala , Uganda

9. United Nations High Commissioner for Refugees , Kampala , Uganda

Abstract

Abstract Newly arrived refugees offer insights into malaria epidemiology in their countries of origin. We evaluated asymptomatic refugee children within 7 days of arrival in Uganda from South Sudan and the Democratic Republic of Congo (DRC) in 2022 for parasitemia, parasite species, and Plasmodium falciparum drug resistance markers. Asymptomatic P. falciparum infections were common in both populations. Coinfection with P. malariae was more common in DRC refugees. Prevalences of markers of aminoquinoline resistance (PfCRT K76T, PfMDR1 N86Y) were much higher in South Sudan refugees, of antifolate resistance (PfDHFR C59R and I164L, PfDHPS A437G, K540E, and A581G) much higher in DRC refugees, and of artemisinin partial resistance (ART-R; PfK13 C469Y and A675V) moderate in both populations. Prevalences of most mutations differed from those seen in Ugandans attending health centers near the refugee centers. Refugee evaluations yielded insights into varied malaria epidemiology and identified markers of ART-R in 2 previously little-studied countries.

Funder

National Institutes of Health

Thrasher Research Fund

Fogarty International Center

Publisher

Oxford University Press (OUP)

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