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Abstract Robust diagnostic tools and surveillance are crucial for malaria control and elimination efforts. Malaria caused by neglected Plasmodium parasites is often underestimated due to the lack of rapid diagnostic tools that can accurately detect these species. While nucleic-acid amplification technologies stand out as the most sensitive methods for detecting and confirming Plasmodium species, their implementation in resource-constrained settings poses significant challenges. Here, we present a Pan Plasmodium recombinase polymerase amplification lateral flow (RPA–LF) assay, capable of detecting all six human infecting Plasmodium species in low resource settings. The Pan Plasmodium RPA-LF assay successfully detected low density clinical infections with a preliminary limit of detection between 10–100 fg/µl for P. falciparum. When combined with crude nucleic acid extraction, the assay can serve as a point-of-need tool for molecular xenomonitoring. This utility was demonstrated by screening laboratory-reared Anopheles stephensi mosquitoes fed with Plasmodium-infected blood, as well as field samples of An. funestus s.l. and An. gambiae s.l. collected from central Africa. Overall, our proof-of-concept Pan Plasmodium diagnostic tool has the potential to be applied for clinical and xenomonitoring field surveillance, and after further evaluation, could become an essential tool to assist malaria control and elimination.

Abstract Vector control strategies have been successful in reducing the number of malaria cases and deaths globally, but the spread of insecticide resistance represents a significant threat to disease control. Insecticide resistance has been reported across Anopheles (An.) vector populations, including species within the An. funestus group. These mosquitoes are responsible for intense malaria transmission across sub-Saharan Africa, including in the Democratic Republic of the Congo (DRC), a country contributing > 12% of global malaria infections and mortality events. To support the continuous efficacy of vector control strategies, it is essential to monitor insecticide resistance using molecular surveillance tools. In this study, we developed an amplicon sequencing (“Amp-seq”) approach targeting An. funestus, and using multiplex PCR, dual index barcoding, and next-generation sequencing for high throughput and low-cost applications. Using our Amp-seq approach, we screened 80 An. funestus field isolates from the DRC across a panel of nine genes with mutations linked to insecticide resistance (ace-1, CYP6P4, CYP6P9a, GSTe2, vgsc, and rdl) and mosquito speciation (cox-1, mtND5, and ITS2). Amongst the 18 non-synonymous mutations detected, was N485I, in the ace-1 gene associated with carbamate resistance. Overall, our panel represents an extendable and much-needed method for the molecular surveillance of insecticide resistance in An. funestus populations.

Abstract Background Malaria vector control in the Democratic Republic of the Congo is plagued by several major challenges, including inadequate infrastructure, lack of access to health care systems and preventative measures, and more recently the widespread emergence of insecticide resistance among Anopheles mosquitoes. Across 26 provinces, insecticide resistance has been reported from multiple sentinel sites. However, to date, investigation of molecular resistance mechanisms among Anopheles vector populations in DRC has been more limited. Methods Adult Anopheles gambiae sensu lato (s.l.) and Anopheles funestus s.l. were collected from two sites in Sud-Kivu province and one site in Haut-Uélé province and PCR-screened for the presence of 11 resistance mutations, to provide additional information on frequency of resistance mechanisms in the eastern DRC, and to critically evaluate the utility of these markers for prospective country-wide resistance monitoring. Results L1014F-kdr and L1014S-kdr were present in 75.9% and 56.7% of An. gambiae s.l. screened, respectively, with some individuals harbouring both resistant alleles. Across the three study sites, L43F-CYP4J5 allele frequency ranged from 0.42 to 0.52, with evidence for ongoing selection. G119S-ace1 was also identified in all sites but at lower levels. A triple mutant haplotype (comprising the point mutation CYP6P4-I236M, the insertion of a partial Zanzibar-like transposable element and duplication of CYP6AA1) was present at high frequencies. In An. funestus s.l. cis-regulatory polymorphisms in CYP6P9a and CYP6P9b were detected, with allele frequencies ranging from 0.82 to 0.98 and 0.65 to 0.83, respectively. Conclusions This study screened the most up-to-date panel of DNA-based resistance markers in An. gambiae s.l. and An. funestus s.l. from the eastern DRC, where resistance data is lacking. Several new candidate markers (CYP4J5, G119S-ace1, the triple mutant, CYP6P9a and CYP6P9b) were identified, which are diagnostic of resistance to major insecticide classes, and warrant future, larger-scale monitoring in the DRC to inform vector control decisions by the National Malaria Control Programme.

This study intended to determine whether LD (Light:Dark) regimens different from the usual 12:12 hours could impair the schizogonic cycle and the synchronism of the rodent malaria parasite Plasmodium chabaudi chabaudi. Five illumination regimens of 12:12 LD, 5:5 LD, 18:18 LD, DD (constant dark) and LL (constant light) were used. Mice were kept in these regimens three months prior to and throughout the experiment. The total and the differential parasitaemia were checked every hour, during more than 24 hours. The parasitaemia data indicated that changes in the LD regimen, except for the LD 18:18, do not affect the length of the developmental cycle of this malaria parasite which remains 24 hours. In both the LL and 18:18 LD regimens, the synchronisation of parasites were impaired, mostly in the LL regimen. Also, we noticed that the schizogony which usually occurs in the dark part of the cycle may happen in the light part too. A circadian rhythm in the frequency of the schizogonic cycle and a time dependent occurrence of ring forms, trophozoites and schizonts were observed. At high parasitaemia, the infection was desynchronised. The total parasitaemia curves displayed a plateau region, followed by a drop at the end of the plateau, and an increase after the schizogony to reach the next plateau level. [ABSTRACT FROM AUTHOR]

Responds to a comment by P. Gautret regarding mice photoperiodicity on the schizogonic rhythm of Plasmodium chabaudi. Possibility of handling conditions affecting the postponement of schizogony; Non-establishment of a clear-cut schizogony time; Explanation of the desynchronization due to the presence of residual schizonts.

Background: Insecticide resistance has become a widespread problem causing a decline in the effectiveness of vector control tools in sub-Saharan Africa. In this situation, ongoing monitoring of vector susceptibility to insecticides is encouraged by the WHO to guide national malaria control programmes. Our study was conducted from April to November 2018 in Tchonka (Sud-Kivu, Democratic Republic of the Congo) and reported primary data on the resistance status of Anopheles funestus and Anopheles gambiae., Methods: Insecticide susceptibility bioassays were performed on wild populations of A. funestus and A. gambiae using WHO insecticide-impregnated papers at discriminating concentration. In addition, PCR was performed to identify mosquito species and to detect kdr and ace-1R mutations involved in insecticide resistance., Results: Bioassay results show resistance to all tested insecticides except pirimiphos-methyl, propoxur, fenitrothion and malathion with a mortality rate ranging from 95.48 to 99.86%. The addition of piperonyl butoxide (PBO) increased the susceptibility of vectors to deltamethrin and alpha-cypermethrin by exhibiting a mortality ranging from 91.50 to 95.86%. The kdr mutation was detected at high frequencies (approximately 0.98) within A. gambiae while ace-1R was not detected., Conclusions: This study provides useful data on the insecticide resistance profiles of malaria vector populations to better manage vector control. Our results highlight that, despite the high level of resistance, organophosphorus compounds and pyrethroids + PBO remain effective against the vectors., (© The Author(s) 2021. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

The mosquito fauna of the Democratic Republic of Congo remains understudied, including that of the province of Sud Kivu. To improve understanding of species presenting Sud Kivu, adult mosquitoes were collected from houses and larvae were collected from standing water at altitudes between 1627 and 1875 m above sea level. Morphological and molecular methods were used to identify the species of Anopheles collected. Six species were found, including several primary and potential secondary malaria vectors. Further work is needed to characterize mosquito populations in Sud Kivu, as well as to improve methods for identifying Anopheles in general.

The efficacy of artemisinin (AR) against malaria has prompted its use as a tea drink in endemic communities. However, there is controversy about its efficacy in this form. Therefore we have investigated the effectiveness of Artemisia annua infusion in infected mice. OF1 mice infected with Plasmodium chabaudi chabaudi were treated for upto 6 days by administration of: water (control group), A. annua infusion (tea group), 0.022 mg AR (AR-equiv. group) and 0.8 mg AR on the first day and 0.4 mg the following day (AR-WHO group). Initially, the parasitaemia increased in all groups. On day 4 it reached 75% in the control group, 72% in the AR-equiv. group, 50% in the tea group and 3% in the AR-WHO group. Mice treated with A. annua tea died after 11 days, while 83% of AR-WHO dose survived. The tea does not decrease the parasitaemia fast enough. We suggest that large clinical trials on human subjects are necessary to ascertain the efficacy of standardized tea. Additionally, other treatment possibilities are suggested.

Four-week-old OF1 mice, infected with synchronized Plasmodium chabaudi chabaudi blood forms, were intraperitoneally injected with the naphthylisoquinoline alkaloid dioncophylline B (10 mg kg(-1) day(-1)) at three consecutive days. The respective groups were treated when rings, trophozoites, and schizonts were predominant. Microscopical observations of thin blood smears were made every two hours after the start of the experiment. A clear dependency of the effectiveness of dioncophylline B treatments on the timing of drug administration was demonstrated. Based upon the evolution of total parasitaemia and the survival rates, it was concluded that ring stages are insensitive to dioncophylline B, while the drug is highly effective when given at the trophozoite stage and partially effective when given at the schizont stage. Dioncophylline B seems to act by inhibiting the haemozoin degradation, as indicated by pigment clumping, and by impairing the segmentation of schizonts.

Detailed total and differential parasitaemia curves of asexual Plasmodium chabaudi chabaudi erythrocytic stages were recorded and analysed. Female, inbred, CBA/Ca mice were infected with the virulent IP-PC1 strain after in vitro synchronization of the parasites. Thin blood smears were made on an hourly basis, and the total and differential parasitaemia of ring forms, trophozoites and schizonts were counted after Giemsa staining. These curves reveal information that remains hidden when less detailed curves are examined: the duration and periodicity of the schizogonic cycle, the existence of a plateau, indications of a schizont withdrawal from the peripheral blood, the timing of the rise of the parasitaemia at each schizogony, and the invasion rate of the merozoites. In the perspective of developing a rational and efficient strategy for chronotherapy of malaria, such information should be taken into account.