Evidence map›Paper›PMID 40241183›Full record

SynthesisAnnals of clinical microbiology and antimicrobials2025

Prevalence of antimalaria drug resistance-conferring mutations associated with sulphadoxine-pyrimethamineine-resistant Plasmodium falciparum in East Africa: a systematic review and meta-analysis.

Wagaw Abebe, Agenagnew Ashagre, Tadesse Misganaw, Zelalem Dejazmach, Getinet Kumie, Marye Nigatie, Abdu Jemal, Zelalem Asmare, Woldeteklehaymanot Kassahun, Solomon Gedfie and 12 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Selective targeting ofAntimicrobial agents and chemotherapy · 2026
    Article
  2. Article
  3. Persistent and CirculatingPathogens (Basel, Switzerland) · 2026
    Article
  4. Article
  5. Review
  6. Article
  7. A review on molecular markers ofJournal of parasitic diseases : official organ of the Indian Society for Parasitology · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Wagaw AbebeDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia. wagawabebe18@gmail.com.
Agenagnew AshagreDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Tadesse MisganawDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Zelalem DejazmachDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Getinet KumieDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Marye NigatieDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Abdu JemalDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Zelalem AsmareDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Woldeteklehaymanot KassahunDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Solomon GedfieDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Ermias GetachewDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Muluken GashawDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Sisay AyanaDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Yalewayker GashawDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Assefa SisayDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Selamyhun TadesseDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Tegegne EshetuDepartment of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Mulat AwokeDepartment of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Birhanu KassanewDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
Atitegeb Abera KidieDepartment of Public Health, College of Health Sciences, Woldia University, PO Box 400, Woldia, Ethiopia.
Biruk Beletew AbateDepartment of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Melese Abate RetaDepartment of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe emergence and spread of drug resistance to antimalarial drugs pose a severe threat to effective malaria control and treatment. Although sulfadoxine-pyrimethamine resistance is well-documented, it is still the drug of choice for treating intermittent resistance. Molecular markers play a crucial role in tracking and understanding the prevalence of antimalarial drug resistance. Currently, there is insufficient information on the prevalence of molecular markers associated with sulfadoxine-pyrimethamine resistance in P. falciparum.

objectiveThis systematic review and meta-analysis aimed to determine the pooled prevalence of antimalaria drug resistance-conferring markers associated with sulphadoxine-pyrimethamineine in Plasmodium falciparum in East Africa.

methodsSystematic searche was performed to retrieve articles from PubMed, Scopus, Science Direct databases, and Google Scholar search engine. Sixteen potential studies that provided important data on markers for sulphadoxine-pyrimethamineine resistance in Plasmodium falciparum were systematically reviewed and analyzed. Nine antimalarial drug resistance markers responsible for sulphadoxine-pyrimethamineine resistance in Plasmodium falciparum were extracted separately into Microsoft Excel and analyzed using STATA 17.0. The inverse of variance was done to evaluate heterogeneity across studies. A funnel plot was used to determine the presence of publication bias. A trim-and-fill-meta-analysis was carried out to generate a bias-adjusted effect estimate. A random effect model was used to determine the pooled prevalence of markers responsible for sulphadoxine-pyrimethamineine resistance. Subgroup analysis was performed based on country and year of publication.

resultsA total of 16 studies were included for this systematic review and meta-analysis.The molecular markers like dhfr (N51I, C59R, S108N, 108N, 59R, and I164L), and dhps (A437G, K540E, & 540E) were selected for meta-analysis. From this meta-analysis, the pooled prevalence of dhfr N51I, dhfr C59R, dhfr S108N, dhfr 108N, dhfr 59R, and dhfr I164L was 88.6%, 85.3%, 89.6%, 92.2%, 71.5%, and 3.9%, respectively. Likewise, the aggregated prevalence of dhps A437G, dhps K540E, and dhps 540E was 90.2%, 80.9%, and 91.5%, respectively. The subgroup analysis based on year of publication showed that the pooled prevalence of dhfr N51I, dhfr C59R, dhfr S108N, dhps A437G, and dhps K540E, in studies conducted 2014-2018 was 97.11%, 90.57%, 96.45%, 90.89%, and 89.45%, respectively, while it was 82.03%, 81.78%, 85.12%, 89.24%, and 73.98%, respectively, in studies conducted 2019-2023. On the other hand, country-based analysis showed that the pooled prevalence of dhfr N51I, dhfr C59R, dhfr S108N, dhps A437G, and dhps K540E, in Kenya was 85.88%, 84.02%, 86.56%, 90.7%, and 77.55%, respectively.

conclusionsThis systematic review and meta-analysis reveal a high prevalence of drug resistance markers  associated with sulphadoxine-pyrimethamine resistance in Plasmodium falciparum across the East African region. This underscores the significant challenges in managing malaria infections caused by Plasmodium falciparum in the region. Therefore, regular monitoring, identification, and limiting of drug-resistance markers and drug-resistant P. falciparum strains must be sustained to ensure the effectiveness of malaria treatment.

Indexed as

AntimalarialsDrug ResistanceMalaria, FalciparumPlasmodium falciparumPyrimethamineSulfadoxineAfrica, EasternDihydropteroate SynthaseDrug CombinationsHumansMutationPrevalenceProtozoan ProteinsTetrahydrofolate DehydrogenaseAntimalarialsDihydropteroate SynthaseDrug Combinationsfanasil, pyrimethamine drug combinationProtozoan ProteinsPyrimethamineSulfadoxineTetrahydrofolate DehydrogenaseDrug resistanceEast AfricaMarkerPlasmodium falciparumPrevalenceSulphadoxine-pyrimethamineine

Identifiers

PMID40241183
PMCPMC12004884

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.