SynthesisBMC infectious diseases2026
Spatio-temporal trends of the prevalence of Plasmodium falciparum antimalarial drug resistance markers across sub-Saharan Africa from 2010 to 2024: a systematic review and meta-analysis.
Synthesis in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Leveraging spatial structure to design spatially-targeted malaria interventions at the community-scale.PLoS computational biology · 2026Article
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8 authors.
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Abstract
backgroundThe emergence and subsequent spread of antimalarial drug resistance represent a significant threat to the efficacy of artemisinin-based combination therapies (ACTs) in sub-Saharan Africa. Multiple molecular markers have been implicated in resistance to artemisinin and its partner drugs. We conducted a systematic review and meta-analysis of studies published between 2010 and 2024 in sub-Saharan Africa.
methodsThe protocol was registered in PROSPERO (CRD42023432718). Studies were identified through PubMed/MEDLINE, Web of Science, Scopus, Embase, and African Journal Online. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers in accordance with the PRISMA 2020 guidelines. Prevalence data for mutations in PfKelch13, Pfcrt, Pfmdr1, and Pfdhfr/Pfdhps were extracted and analysed using random-effects models, with pooled prevalence estimates generated using a generalized linear mixed model (GLMM) with logit transformation. Between-study heterogeneity was assessed using Cochran's Q and I
resultsA total of 172 studies on PfKelch13, 182 on Pfcrt, 196 on Pfmdr1, and 176 on Pfdhfr/Pfdhps were included. From 2014 to 2023, validated PfKelch13 mutations exhibited marked spatial and temporal heterogeneity, with R622I, R561H, and A675V expanding primarily in East Africa, reaching prevalences of 10-25% in Rwanda, Uganda, and Tanzania. In Central Africa, emergence was observed in 2021 at low levels (below 5%), while West Africa reported only sporadic low-prevalence (below 1%) detections. In contrast, resistance to some partner drugs declined substantially across Africa, with Pfcrt K76T decreasing from 76% (95% CI: 49% - 91%; I
conclusionOverall, the temporal and regional patterns of antimalarial drug resistance molecular markers across sub-Saharan Africa underscore the need for sustained molecular surveillance tailored to local epidemiological trends of resistance markers. REGISTRATION: Protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42023432718).
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