Table

Volume 32, Number 4—April 2026

Border Region Surveillance of Malaria Drug Resistance, Northern Burundi, 2023–2024

Denis Niyomwungere

, Pierre Sinarinzi, Emmanuelle Caspar, Lucas Thiebaut, Pierre-Emeric Strubel, Yssimini Nadège Guillène Tibiri, Laurence Ma, Jérôme Rurihafi, Pierre Ndizeyimana, Pierre Hakizimana, Nestor Niyizompa, Adélin Witonze, Vénant Ndayiragije, Floride Ndayisenga, Malachie Ndikumukiza, Olive Niyonkuru, Jean Claude Niyonsaba, Césaire Bangirinama, Jolis Lazare Bigirimana, Nicaise Ntahondi, Landrine Mugisha, Marcelline Nibakire, Néhémie Nzoyikorera, Denis Sinzinkayo, Didier Menard

, and Joseph Nyandwi

Author affiliation: Institut National de Santé Publique, Bujumbura, Burundi (D. Niyomwungere, P. Ndizeyimana, P. Hakizimana, J. Nyandwi); Programme National Intégré de Lutte contre le Paludisme, Bujumbura (P. Sinarinzi, J. Rurihafi, N. Niyizompa, A. Witonze, F. Ndayisenga, L. Mugisha, M. Nibakire, N. Nzoyikorera); Malaria Genetics and Resistance Team, Pathogens Host Arthropods Vectors Interactions Unit, University of Strasbourg, Strasbourg, France (E. Caspar, L. Thiebaut, P.-E. Strubel, Y.N.G. Tibiri, D. Menard); Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso (Y.N.G. Tibiri); Biomics Platform, Institut Pasteur, Université Paris Cite, Paris, France (L. Ma); Centre Hospitalo-universitaire de Kamenge, Bujumbura (V. Ndayiragije, M. Ndikumukiza, O. Niyonkuru, C. Bangirinama, J.L. Bigirimana, N. Ntahondi); Université du Burundi, Bujumbura (M. Ndikumukiza, D. Sinzinkayo, J. Nyandwi); Tanganyika Care Hospital, Bujumbura (J.C. Niyonsaba); Malaria Parasite Biology and Vaccines, INSERM Unit 1347, ParasitInnov, Institut Pasteur, Université Paris Cité, Paris (D. Menard); Laboratory of Parasitology and Medical Mycology, CHU Strasbourg, Strasbourg (D. Menard); Institut universitaire de France, Paris (D. Menard)

Main Article

Baseline characteristics and day 3 parasitologic outcomes for patients with Plasmodium falciparum malaria, northern Burundi, December 2023–June 2024*

Baseline characteristics	Kirundo Province			Ngozi Province				Total	p value
Baseline characteristics	Kirundo	Vumbi	Total	Buye	Kiremba	Ngozi	Total	Total	p value
No. patients	170	82	252	97	30	44	171	423	–
Gender ratio, M/F	0.9	1.5	1.1	0.8	2.0	1.0	1.0	1.0	0.77
Age, mo
Median	32	30	31	28	29	32	30	30	0.5
95% CI	27–36	22.2–33	27–34.3	23–35.5	17–36.65	28.5–36	25.9–34	28–32	–
IQR	19–47	13.75–38.25	18–46	14–42	15–42	20.75–45	16–42	17–45	–
Weight, kg
Median	11	10	11	10	11.5	10	10	10	0.5
95% CI	10–12	9–11.2	10–11	10–11	9.2–13.8	10–12.2	10–11	10–11	–
IQR	9–13.5	8.1–12.9	9–13	8–13	10–13	10–14	9–13	9–13	–
Temperature, °C
Median	39.0	38.3	38.6	37.8	38.1	38.7	38.4	38.5	0.01
95% CI	38.6–39.0	38.0–38.5	38.4–38.9	37.8–38.4	37.8–39.0	38.5–38.9	38.0–38.5	38.4–38.6	–
IQR	38.0–39.6	38.0–38.9	38.0–39.2	37.4–38.9	37.7–39.0	38.3–39.0	37.7–39.0	37.8–39.0	–
Pretreatment asexual P. falciparum density, parasites/µL
Median	42,400	10,543	36,734	10,745	12,743	27,661	19,374	27,313	0.01
95% CI	33,663–54,525	7,499–39,836	25,325–46,160	3,846–26,436	8,028–38,878	15,887–41,680	10,733–26,650	22,511–35,539	–
IQR	7,566–108,166	2,759–72,886	4,615–102,933	1,625–48,692	5,128–44,000	9,746–59,628	2,400–51,912	3,521–79,513	–
Pretreatment sexual P. falciparum density, parasites/µL, %	1.2	3.7	2	7.4	3.3	22.0	10.2	5.3	0.0003
Mixed infections with other species, %
P. vivax	0	0	0	0	0	0	0	0	0.08
P. malariae	0	0	0	1.1	0	2.4	1.2	0.5
P. ovale	0	0	0	0	0	0	0	0
Day 3 positivity rate, %†	1.8	13.6	5.7	2.1	0	7.3	3.0	4.5	0.06
Day 3 asexual P. falciparum density, parasites/µL
Median	1,480	240	260	100	–	1,832	103	260	0.96
95% CI	–	177–281	200–1,522	–	–	–	–	175–1,290	–
IQR	5,475–23,172	192–275	202–1,140	98–103	–	494–13,381	85–5681	141–1,659	–
Day 3 sexual P. falciparum density, parasites/µL, %	1.2	1.2	1.2	4.2	10.0	2.4	4.8	2.6	0.02

*Demographic, clinical, and parasitologic parameters recorded at enrollment and on day 3 after initiation of artemether/lumefantrine treatment. The study covered 5 districts: Kirundo and Vumbi in Kirundo Province; and Buye, Kiremba, and Ngozi in Ngozi Province. Data are disaggregated by site and province. Continuous variables are reported as medians with IQRs and 95% CIs; categorical variables are expressed as percentages. p values reflect statistical comparisons between the 2 provinces (Kirundo vs. Ngozi); bold indicates significant p values. IQR, interquartile range; –, not applicable. †Day 3 positivity indicates the presence of microscopically detectable asexual P. falciparum parasitemia on day 3 after treatment initiation.

Main Article

Page created: March 10, 2026

Page updated: April 15, 2026

Page reviewed: April 15, 2026

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