A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda

Malaria has been and remains a significant challenge in Africa and other endemic settings. Roughly, 95% of global morbidity and mortality due to malaria occurs within African populations and affects millions of individuals, especially those living in sub-Saharan countries, predominantly due to disea...

Full description

Saved in:
Bibliographic Details
Main Authors: Muharib Alruwaili, Abozer Elderdery, Emad Manni, Jeremy Mills
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Tropical Medicine and Infectious Disease
Subjects:
Online Access:https://www.mdpi.com/2414-6366/10/4/89
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850180890119897088
author Muharib Alruwaili
Abozer Elderdery
Emad Manni
Jeremy Mills
author_facet Muharib Alruwaili
Abozer Elderdery
Emad Manni
Jeremy Mills
author_sort Muharib Alruwaili
collection DOAJ
description Malaria has been and remains a significant challenge in Africa and other endemic settings. Roughly, 95% of global morbidity and mortality due to malaria occurs within African populations and affects millions of individuals, especially those living in sub-Saharan countries, predominantly due to disease complications. Cultural factors such as unawareness of and disinterest in using recommended preventive tools and combating the primary host (i.e., the female Anopheles mosquito) play a significant role. This host transmits the malaria-causing <i>Plasmodium</i> parasite by biting an infected individual and spreading it to humans. The current overview focuses on the molecular markers associated with antimalarial drug resistance in <i>Plasmodium falciparum</i> (<i>P. falciparum</i>) in Rwanda, considered an exemplar of sub-Saharan countries where malaria is prevalent and effective policies on the development of malaria treatment, approved recently by WHO in 2025, have been adopted. The prevalence of mutations in key resistance genes, including <i>pfcrt</i>, <i>pfmdr1</i>, and <i>pfdhfr/pfdhps</i>, are linked to resistance against common antimalarial drugs such as chloroquine and sulfadoxine-pyrimethamine (SP). In addition, the <i>Plasmodium falciparum</i> kelch13 (<i>pfk13</i>) gene is linked to resistance against artemisinin, as its mutations can cause delayed parasite clearance and treatment failure. Despite changes in therapeutic use policies owing to high prevalence of variant alleles, which reduce the drug’s efficacy resistance to SP, the gene persists in Rwanda. Malaria parasites are becoming more resistant to chloroquine, leading to diminished effectiveness and slower recovery or treatment failure. Surveillance data reported from several studies provide crucial insights into the evolving trends of resistance markers and are vital for guiding treatment protocols and informing therapeutic use policy decisions. It is important that we continue to maintain and develop the effectiveness of malaria prevention strategies and treatments, due to the multiple types of resistance found in the population.
format Article
id doaj-art-646c559925ec4eeb9dff1ce31b754a93
institution OA Journals
issn 2414-6366
language English
publishDate 2025-03-01
publisher MDPI AG
record_format Article
series Tropical Medicine and Infectious Disease
spelling doaj-art-646c559925ec4eeb9dff1ce31b754a932025-08-20T02:18:01ZengMDPI AGTropical Medicine and Infectious Disease2414-63662025-03-011048910.3390/tropicalmed10040089A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in RwandaMuharib Alruwaili0Abozer Elderdery1Emad Manni2Jeremy Mills3Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi ArabiaDepartment of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi ArabiaDepartment of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi ArabiaSchool of Medicine, Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth PO1 2DT, UKMalaria has been and remains a significant challenge in Africa and other endemic settings. Roughly, 95% of global morbidity and mortality due to malaria occurs within African populations and affects millions of individuals, especially those living in sub-Saharan countries, predominantly due to disease complications. Cultural factors such as unawareness of and disinterest in using recommended preventive tools and combating the primary host (i.e., the female Anopheles mosquito) play a significant role. This host transmits the malaria-causing <i>Plasmodium</i> parasite by biting an infected individual and spreading it to humans. The current overview focuses on the molecular markers associated with antimalarial drug resistance in <i>Plasmodium falciparum</i> (<i>P. falciparum</i>) in Rwanda, considered an exemplar of sub-Saharan countries where malaria is prevalent and effective policies on the development of malaria treatment, approved recently by WHO in 2025, have been adopted. The prevalence of mutations in key resistance genes, including <i>pfcrt</i>, <i>pfmdr1</i>, and <i>pfdhfr/pfdhps</i>, are linked to resistance against common antimalarial drugs such as chloroquine and sulfadoxine-pyrimethamine (SP). In addition, the <i>Plasmodium falciparum</i> kelch13 (<i>pfk13</i>) gene is linked to resistance against artemisinin, as its mutations can cause delayed parasite clearance and treatment failure. Despite changes in therapeutic use policies owing to high prevalence of variant alleles, which reduce the drug’s efficacy resistance to SP, the gene persists in Rwanda. Malaria parasites are becoming more resistant to chloroquine, leading to diminished effectiveness and slower recovery or treatment failure. Surveillance data reported from several studies provide crucial insights into the evolving trends of resistance markers and are vital for guiding treatment protocols and informing therapeutic use policy decisions. It is important that we continue to maintain and develop the effectiveness of malaria prevention strategies and treatments, due to the multiple types of resistance found in the population.https://www.mdpi.com/2414-6366/10/4/89malaria<i>Plasmodium falciparum</i><i>pfcrt</i><i>pfmdr1</i><i>pfdhfr/pfdhps</i>artemisinin
spellingShingle Muharib Alruwaili
Abozer Elderdery
Emad Manni
Jeremy Mills
A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda
Tropical Medicine and Infectious Disease
malaria
<i>Plasmodium falciparum</i>
<i>pfcrt</i>
<i>pfmdr1</i>
<i>pfdhfr/pfdhps</i>
artemisinin
title A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda
title_full A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda
title_fullStr A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda
title_full_unstemmed A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda
title_short A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda
title_sort narrative review on the prevalence of i plasmodium falciparum i resistance mutations to antimalarial drugs in rwanda
topic malaria
<i>Plasmodium falciparum</i>
<i>pfcrt</i>
<i>pfmdr1</i>
<i>pfdhfr/pfdhps</i>
artemisinin
url https://www.mdpi.com/2414-6366/10/4/89
work_keys_str_mv AT muharibalruwaili anarrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda
AT abozerelderdery anarrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda
AT emadmanni anarrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda
AT jeremymills anarrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda
AT muharibalruwaili narrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda
AT abozerelderdery narrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda
AT emadmanni narrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda
AT jeremymills narrativereviewontheprevalenceofiplasmodiumfalciparumiresistancemutationstoantimalarialdrugsinrwanda