Prevalence of Plasmodium falciparum artemisinin-based combination therapy gene mutation in chukwuodumegwu ojukwu university teaching hospital Awka

Background: Monitoring Plasmodium falciparum Kelch 13 (pfk13) gene mutations linked to artemisinin resistance is critical for understanding the spread of drug-resistant malaria. Although pfk13 mutations have been observed in various regions of Nigeria, limited molecular epidemiological studies on field P. falciparum isolates have been conducted. Aim: This study aimed to evaluate the prevalence of pfk13 gene mutations associated with artemisinin resistance in P. falciparum isolates from malaria patients at Chukwuemeka Odumegwu Ojukwu Teaching Hospital (COOUTH), Anambra State, Nigeria. Method: A total of 186 participants were included, consisting of 98 females (52.7%) and 88 males (47.3%), with 51.1% in the 18-30 age group. Most participants had secondary (43.0%) or tertiary (35.5%) education. The largest occupational group was students (40.3%). Blood samples were collected from patients diagnosed with malaria using rapid diagnostic tests (RDT) and microscopy. The pfk13 gene was amplified via nested polymerase chain reaction (PCR) and sequenced with ABI 3031 sanger sequencer to detect polymorphisms. Result: The study revealed five distinct pfk13 mutant alleles: G548G, A577S, P615P, A626A, and V638D. Two non-synonymous mutations (A577S and V638D) occurred at positions 1732 and 1908, while three synonymous mutations (G548G, A577S, and A626A) were detected at different positions. None of the mutations associated with delayed parasite clearance or artemisinin resistance, such as C580Y, R539T, Y493H, or M476I, were found in the analyzed samples. Conclusion: This study identified new pfk13 gene polymorphisms in P. falciparum isolates from Anambra State. Although no mutations linked to artemisinin resistance were found, the detection of non-synonymous mutations emphasizes the importance of ongoing genomic surveillance to monitor resistance patterns and safeguard the efficacy of artemisinin-based combination therapies (ACTs) in malaria control.