Absence of Validated Artemisinin Combination Therapy Resistance Markers in High and Low Malaria Transmission Seasons in Kano and Jigawa States, Nigeria

Abstract

Introduction: The first line treatment of uncomplicated malaria (ACT) is under threat due to evolution of drug-resistant P. falcifarum species. Five amino acid on pfk13 propeller domain has been established to account for ACT resistance alongside candidate mutations in some Asian countries. Nigeria is carrying the largest burden of mortality and morbidity due to malaria despite huge investment in malaria control and treatment. Monitoring of these biomarkers in Pfk13 gene is paramount in understanding the extent at which the resistant species spread in the country. Aim: This study aimed at surveying the presence of validated and candidate mutations in low and high malaria transmission seasons. Method: P falcifarum clinical isolates were collected from malaria patients attending some public health facilities in Kano municipal, Kura and Hadejia LGAs. The propeller domain of Pfk13 genes were amplified by nested PCR and amplicons were sequenced to identify the validated, candidate and novel polymorphisms. Results: None of the validated and candidate mutations conferring ACT resistance could be detected in all the 50 Pf haplotypes across the study sites. Conclusion: Based on these results, it may be concluded that ACT treatment policy for uncomplicated malaria is not under immediate threat of resistance development in the states.