Analysis of Drug Resistance Genes in Plasmodium falciparum Isolates from Malaria Patients Across the North Central Zone

Antimalarial drug resistance in Plasmodium falciparum threatens the efficacy of current first-line artemisinin-based combination therapy (ACT), making molecular resistance surveillance across the North Central zone of Nigeria a critical public health priority. This study analyses drug resistance genes in Plasmodium falciparum isolates from malaria patients across North Central Nigeria, targeting resistance markers for chloroquine, sulphadoxine-pyrimethamine (SP), and artemisinin. Blood samples from 200 malaria-positive patients at hospitals in Benue, Niger, Kogi, and Nassarawa States were collected. Parasite DNA was extracted from dried blood spots and subjected to nested PCR and sequencing of pfcrt, pfmdr1, pfkelch13, dhfr, and dhps genes associated with chloroquine, ACT, and SP resistance. pfcrt K76T mutation conferring chloroquine resistance was present in 61 percent of isolates. pfmdr1 N86Y was detected in 42 percent. Triple dhfr mutations (N51I, C59R, S108N) associated with high-level SP resistance were present in 71 percent. No validated artemisinin resistance markers in the pfkelch13 propeller domain were identified, indicating ACT susceptibility is currently preserved in this zone. The study provides a molecular resistance baseline for the North Central zone and supports continued ACT use while advocating for chloroquine discontinuation and intensified resistance surveillance. Keywords: Plasmodium falciparum, drug resistance genes, artemisinin, North Central Nigeria, malaria surveillance