Resistance of Plasmodium falciparum to antimalarial drugs remains a major public health concern in endemic regions. Polymorphisms in the pfmdr1 gene, particularly N86Y and Y184F, have been implicated in modulating parasite susceptibility to artemisinin-based combination therapies (ACTs). This study aimed to investigate the molecular epidemiology of P. falciparum and the distribution of pfmdr1 polymorphisms in Daloa, western C？te d’Ivoire. A cross-sectional study was conducted among individuals with suspected clinical malaria at the Regional Center for Mutuality and Social Works in Schools (CREMOSS) of Daloa. Blood samples were collected for parasitological and molecular analyses. Detection of P. falciparum and genotyping of pfmdr1 polymorphisms were performed using standard molecular techniques. Associations between infection status, genetic markers, and sociodemographic variables were also assessed. The overall molecular prevalence of P. falciparum was 50.27%, indicating sustained transmission within the study population. No significant association was observed between infection status and sex, whereas age influenced infection risk, with children aged 6 - 15 years being the most affected group. Analysis of the pfmdr1 gene revealed a high prevalence of the mutant alleles 86Y and 184F, with a marked predominance of the double mutant haplotype 86Y-184F (65.00 %). The wild-type haplotype N86-Y184 was infrequent, while the 86Y-Y184 haplotype was nearly absent. No significant association was found between pfmdr1 polymorphisms and sociodemographic variables. The high prevalence of pfmdr1 mutant alleles and the predominance of the 86Y-184F haplotype suggest ongoing selection pressure, likely associated with the use of antimalarial drugs within the study population. The low frequency of wild-type genotypes may reflect a progressive decline in drug-sensitive parasites. These findings highlight the need for continuous molecular surveillance to monitor changes in ACT efficacy and guide malaria control strategies.
References
[1]
Gouamene, T.J.R., Edi, C.A.V., Kwadio, E., Gbalegba, C.G.N., Zahouli, J.Z.B. and Koudou, B.G. (2024) Malaria Transmission in the Coastal Zone and in the Centre of C？te D’ivoire during the Dry Season. MalariaJournal, 23, Article No. 400. https://doi.org/10.1186/s12936-024-05176-7
[2]
WHO (2024) World Malaria Report 2024: Addressing Inequity in the Global Malaria Response. https://iris.who.int/items/91d8a7a4-4513-48c0-aee9-95a5fe567c47
[3]
Rosenthal, P.J., Asua, V. and Conrad, M.D. (2024) Emergence, Transmission Dynamics and Mechanisms of Artemisinin Partial Resistance in Malaria Parasites in Africa. NatureReviewsMicrobiology, 22, 373-384. https://doi.org/10.1038/s41579-024-01008-2
[4]
Luth, M.R., Godinez-Macias, K.P., Chen, D., Okombo, J., Thathy, V., Cheng, X., et al. (2024) Systematic in Vitro Evolution in Plasmodium falciparum Reveals Key Determinants of Drug Resistance. Science, 386, eadk9893. https://doi.org/10.1126/science.adk9893
[5]
Mathurin, K., Innocent, A.A., Bernardin, A.A., Dieudonné, S., Thomas, K.K. and Abiba, S.T. (2019) Prevalence and Genetic Diversity of Plasmodium falciparum in Patients Attending Regional Health Center in Daloa, C？te D’ivoire. International JournalofGeneticsandMolecularBiology, 11, 50-56. https://doi.org/10.5897/ijgmb2019.0179
[6]
Beke, O.A., Assi, S., Kokrasset, A.P.H., Dibo, K.J.D., Tanoh, M.A., Danho, M., et al. (2023) Implication of Agricultural Practices in the Micro-Geographic Heterogeneity of Malaria Transmission in Bouna, C？te D’ivoire. MalariaJournal, 22, Article No. 313. https://doi.org/10.1186/s12936-023-04748-3
[7]
Kokori, E., Olatunji, G., Akinboade, A., Akinoso, A., Egbunu, E., Aremu, S.A., et al. (2024) Triple Artemisinin-Based Combination Therapy (TACT): Advancing Malaria Control and Eradication Efforts. MalariaJournal, 23, Article No. 25. https://doi.org/10.1186/s12936-024-04844-y
[8]
Assefa, A., Fola, A.A. and Tasew, G. (2024) Emergence of Plasmodium falciparum Strains with Artemisinin Partial Resistance in East Africa and the Horn of Africa: Is There a Need to Panic? MalariaJournal, 23, Article No. 34. https://doi.org/10.1186/s12936-024-04848-8
[9]
Konaté-Touré, A., Gnagne, A.P., Bedia-Tanoh, A.V., Menan, E.I.H. and Yavo, W. (2024) Increase of Plasmodium falciparum Parasites Carrying Lumefantrine-Tolerance Molecular Markers and Lack of South East Asian Pfk13 Artemisinin-Resistance Mutations in Samples Collected from 2013 to 2016 in C？te D’ivoire. JournalofParasiticDiseases, 48, 59-66. https://doi.org/10.1007/s12639-023-01640-4
[10]
Laird, V.R., Plucinski, M.M., Venkatesan, M., Rondini, K.A., Randrianarivelojosia, M., Andriamananjara, M.N., et al. (2025) Plasmodium falciparum Multidrug Resistance 1 Gene Polymorphisms Associated with Outcomes after Anti-Malarial Treatment. MalariaJournal, 24, Article No. 186. https://doi.org/10.1186/s12936-025-05248-2
[11]
Snounou, G. and Singh, B. (n.d.) Nested PCR Analysis of Plasmodium Parasites. In: Doolan, D.L., Ed., MalariaMethodsandProtocols, Humana Press, 189-203. https://doi.org/10.1385/1-59259-271-6:189
[12]
Millogo, K.S., Kaboré, B., Sondo, P., Compaoré, E.W., Kouevi, A.F.C., Kambou, S.A.E., et al. (2024) Trend of N86Y and Y184F Mutations in Pfmdr1 Gene in Children under Seasonal Malaria Chemoprevention Coverage in Nanoro, Burkina Faso. ActaParasitologica, 69, 1967-1976. https://doi.org/10.1007/s11686-024-00923-x
[13]
Ravaoarisoa, é., Andrianaranjaka, V.H.I., Ramanantsahala, A.D., et al. (2022) Pcr-rflp Genotyping of pfcrt and pfmdr1 in Plasmodium falciparum Isolates from Children in Vatomandry, Madagascar. MedecineTropicale et Sante Internationale, 2, mtsi.v2i2.2022.198.
[14]
Duraisingh, M.T., Jones, P., Sambou, I., von Seidlein, L., Pinder, M. and Warhurst, D.C. (2000) The Tyrosine-86 Allele of the Pfmdr1 Gene of Plasmodium falciparum Is Associated with Increased Sensitivity to the Anti-Malarials Mefloquine and Artemisinin. MolecularandBiochemicalParasitology, 108, 13-23. https://doi.org/10.1016/s0166-6851(00)00201-2
[15]
Mwesigwa, A., Ocan, M., Musinguzi, B., Nante, R.W., Nankabirwa, J.I., Kiwuwa, S.M., et al. (2024) Plasmodium falciparum Genetic Diversity and Multiplicity of Infection Based on Msp-1, Msp-2, Glurp and Microsatellite Genetic Markers in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. MalariaJournal, 23, Article No. 97. https://doi.org/10.1186/s12936-024-04925-y
[16]
Opoku Afriyie, S., Addison, T.K., Gebre, Y., Mutala, A., Antwi, K.B., Abbas, D.A., et al. (2023) Accuracy of Diagnosis among Clinical Malaria Patients: Comparing Microscopy, RDT and a Highly Sensitive Quantitative PCR Looking at the Implications for Submicroscopic Infections. MalariaJournal, 22, Article No. 76. https://doi.org/10.1186/s12936-023-04506-5
[17]
Ahmad, A., Mohammed, N.I., Joof, F., Affara, M., Jawara, M., Abubakar, I., et al. (2023) Asymptomatic Plasmodium falciparum Carriage and Clinical Disease: A 5-Year Community-Based Longitudinal Study in the Gambia. MalariaJournal, 22, Article No. 82. https://doi.org/10.1186/s12936-023-04519-0
[18]
Neyer, P.J., Kaboré, B., Nakas, C.T., Hartmann, B., Post, A., Diallo, S., et al. (2023) Exploring the Host Factors Affecting Asymptomatic Plasmodium falciparum Infection: Insights from a Rural Burkina Faso Study. MalariaJournal, 22, Article No. 252. https://doi.org/10.1186/s12936-023-04686-0
[19]
Morlino, C., Byrne, I., Achan, J., Baraka, V., Barry, A., Bousema, T., et al. (2025) Barriers to Uptake and Implementation of Malaria Chemoprevention in School-Aged Children: A Stakeholder Engagement Meeting Report. FrontiersinTropicalDiseases, 6, Article ID: 1480907. https://doi.org/10.3389/fitd.2025.1480907
[20]
Tarama, C.W., Soré, H., Yade, M.S., Niyomwungere, D., Débé, S., Kinda, R., et al. (2026) School-Aged Children as a Silent Reservoir of Plasmodium falciparum: Findings from a Cross-Sectional Survey Conducted in Burkina Faso in 2022. MalariaJournal, 25, Article No. 174. https://doi.org/10.1186/s12936-026-05867-3
[21]
Matrevi, S.A., Adams, T., Tandoh, K.Z., Opoku-Agyeman, P., Bruku, S., Ennuson, N.A., et al. (2024) Putative Molecular Markers of Plasmodium falciparum Resistance to Antimalarial Drugs in Malaria Parasites from Ghana. FrontiersinEpidemiology, 4, Article ID: 1279835. https://doi.org/10.3389/fepid.2024.1279835
[22]
Tadele, G., Jawara, A., Oboh, M., Oriero, E., Dugassa, S., Amambua-Ngwa, A., et al. (2023) Clinical Isolates of Uncomplicated Falciparum Malaria from High and Low Malaria Transmission Areas Show Distinct Pfcrt and Pfmdr1 Polymorphisms in Western Ethiopia. MalariaJournal, 22, Article No. 171. https://doi.org/10.1186/s12936-023-04602-6
[23]
Walker, A., Ross, A. and Nsanzabana, C. (2025) Changes in the Prevalence of Antimalarial Partner Drug Resistance Markers and Policy in 6 Sub-Saharan African Countries from 2000 to 2021: A Systematic Review. OpenForumInfectiousDiseases, 12, ofaf508. https://doi.org/10.1093/ofid/ofaf508
[24]
Okell, L.C., Reiter, L.M., Ebbe, L.S., Baraka, V., Bisanzio, D., Watson, O.J., et al. (2018) Emerging Implications of Policies on Malaria Treatment: Genetic Changes in the pfmdr-1 Gene Affecting Susceptibility to Artemether-Lumefantrine and Artesunate-Amodiaquine in Africa. BMJGlobalHealth, 3, e000999. https://doi.org/10.1136/bmjgh-2018-000999
Duvalsaint, M., Conrad, M.D., Tukwasibwe, S., Tumwebaze, P.K., Legac, J., Cooper, R.A., et al. (2021) Balanced Impacts of Fitness and Drug Pressure on the Evolution of PfMDR1 Polymorphisms in Plasmodium falciparum. MalariaJournal, 20, Article No. 292. https://doi.org/10.1186/s12936-021-03823-x
[27]
Baina, M.T., Djontu, J.C., Mbama Ntabi, J.D., Mfoutou Mapanguy, C.C., Lissom, A., Vouvoungui, C.J., et al. (2024) Polymorphisms in the Pfcrt, Pfmdr1, and Pfk13 Genes of Plasmodium falciparum Isolates from Southern Brazzaville, Republic of Congo. ScientificReports, 14, Article No. 27988. https://doi.org/10.1038/s41598-024-78670-2
