ReviewThe Lancet. Microbe2020
Molecular surveillance of antimalarial partner drug resistance in sub-Saharan Africa: a spatial-temporal evidence mapping study.
Review in The Lancet. Microbe, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- The Global Landscape ofPathogens (Basel, Switzerland) · 2026Pooled it
- Molecular surveillance of antimalarial drug resistance genes in Nigeria: a systematic review and roadmap to malaria elimination.BMC medical genomics · 2025Pooled it
- Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Comprehensive genomic study of Plasmodium falciparum in Sierra leone: genetic variation and resistance patterns.BMC genomics · 2025Article
- Plasmodium falciparum isolates: ex vivo drug response.The Journal of antimicrobial chemotherapy · 2025Article
- Bridging the Gap from Molecular Surveillance to Programmatic Decisions for Malaria Control and Elimination.The American journal of tropical medicine and hygiene · 2025Review
- A virus associated with the zoonotic pathogenbioRxiv : the preprint server for biology · 2024Article
- Genome Analysis ofChina CDC weekly · 2024Article
- Role of seasonal importation and genetic drift on selection for drug-resistant genotypes ofJournal of the Royal Society, Interface · 2024Article
- Enhancing Pharmacovigilance in Côte d'Ivoire: Impact of GSK's Training and Mentoring Pilot Project in the Abidjan Region.Drug safety · 2024Article
- A virus associated with the zoonotic pathogenVirus evolution · 2024Article
- Seasonal malaria chemoprevention in a context of high presumed sulfadoxine-pyrimethamine resistance: malaria morbidity and molecular drug resistance profiles in South Sudan.Malaria journal · 2023Article
- Sampling for malaria molecular surveillance.Trends in parasitology · 2023Review
- Role of Seasonal Importation and Random Genetic Drift on Selection for Drug-Resistant Genotypes ofbioRxiv : the preprint server for biology · 2023Article
- Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique.Communications biology · 2023Article
- Tracking antimalarial drug resistance using mosquito blood meals: a cross-sectional study.The Lancet. Microbe · 2023Article
- Impact of Drug Exposure on Resistance Selection Following Artemether-Lumefantrine Treatment for Malaria in Children With and Without HIV in Uganda.Clinical pharmacology and therapeutics · 2023Article
- Plasmodium falciparum resistance to artemisinin-based combination therapies.Current opinion in microbiology · 2022Review
- Molecular surveillance for operationally relevant genetic polymorphisms in Plasmodium falciparum in Southern Chad, 2016-2017.Malaria journal · 2022Article
- Breaking the cycle of malaria treatment failure.Frontiers in epidemiology · 2022Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMolecular markers for antimalarial drug resistance can be used to rapidly monitor the emergence and spatial distribution of resistance to artemisinin-based combination therapies (ACTs). Little has been done to analyse molecular surveillance efforts or to assess surveillance coverage. This study aimed to develop an evidence map to characterise the spatial-temporal distribution and sampling methodologies of drug resistance surveillance in sub-Saharan Africa, specifically focusing on markers associated with ACT partner drugs.
methodsBy use of a systematic search, we identified studies that reported data on the following mutations associated with ACT partner drug resistance:
findingsOur search yielded 254 studies encompassing 492 year-specific and location-specific surveys from 35 malaria-endemic countries, the most complete set of molecular partner drug surveillance data to date. We observed a median time lag of 3·1 years (95% CI 1·0-7·7) from final sample acquisition to publication. 22 (49%) of the 44 countries in the study region conducted, on average, one or fewer studies every 3 years. The locations of surveillance sites were positively associated with urbanicity (p<0·0001), and the abundance of country-level data was associated with reported donor funding in 2004-18 (p=0·0011) and local government funding in 2004-09 (p=0·014). Nearly all molecular markers displayed significant regional trends over time and global spatial autocorrelation in space. For selected countries with more widespread coverage of surveillance data, some markers also displayed spatial heterogeneity.
interpretationIn most sub-Saharan countries, molecular data on antimalarial resistance might not be representative of the temporal and geographic heterogeneity of partner drug resistance, and likely do not represent the true spatially dependent distribution of partner drug resistance. Our results highlight several inefficiencies that can be improved upon to develop more accurate data landscapes, including the expansion of sentinel surveillance systems, syndemic usage of research samples, and increased participation in reporting published and unpublished data to centralised platforms.
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