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

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

Cedar L Mitchell  1 , Mark M Janko  2 , Robert Verity  3 , Melchior M Kashamuka  4 , Jeffrey A Bailey  5 , Antoinette K Tshefu  4 , Jonathan B Parr  6 , Jonathan J Juliano  1   6
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Close Proximity to Mining Is Associated with Increased Prevalence of the Drug Resistance-Associated Mutation dhps540E in Eastern Democratic Republic of the Congo

Cedar L Mitchell et al. Am J Trop Med Hyg. .

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.

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Conflict of interest statement

Disclosure: Ethical approval was obtained from the University of North Carolina Institutional Review Board and the Kinshasa School of Public Health.

Authors’ contributions: C. L. Mitchell and J. J. Juliano wrote the original manuscript draft, and M. M. Janko and J. B. Parr contributed substantially to revisions. C. L. Mitchell, M. M. Janko, and J. J. Juliano conceptualized and designed the study. C. L. Mitchell analyzed the data and performed analytic experiments, M. M. Janko and J. J. Juliano provided analytical guidance, and R. Verity, M. M. Kashamuka, J. A. Bailey, A. K. Tshefu, and J. B. Parr facilitated access to the data and contributed analysis materials. All authors read and approved the final manuscript.

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