Assessment of Plasmodium falciparum Resistance to Artemisinin Among Attendees of Selected Health Facilities in Rivers State, Nigeria

Abstract

Across-sectional research, aimed at evaluating artemisinin drug resistance in falciparum malaria patients attending selected health facilities in Rivers State, Nigeria, was done between July 2019 and March 2020. The selected hospitals were Rivers State University Teaching Hospital (RSUTH), University of Port Harcourt Teaching Hospital (UPTH) and Model Primary Health Centre (MPHC), Iriebe, all in Rivers State, Nigeria. The study population was 1000 subjects with an overall malaria prevalence of 25.5%, the number of enrolled participants from RSUTH was 494 with the highest infection rate of 32.5%, 300 from UPTH which had the least (11%) prevalence, while 206 were from MPHC, Iriebe with 29.6% prevalence accordingly. Blood samples were collected from these subjects by phlebotomy method. Plasmodium falciparum parasite was determined by microscopy using thick and thin blood films stained with Giemsa staining technique. Artemisinin resistance markers were assessed using the nested polymerase chain reaction method. The study population consisted of children, pregnant women, and other adults of both sexes. Out of the forty-seven isolates assayed for K13 and ATPase 6 genes, who carried the artemisinin-sensitive wild-type allele, none of these isolates exhibited both ATPase 6 and Kelch -13 resistance genes/mutations hence no single nucleotide polymorphism was observed. This suggests that this part of the country is not under the threat of artemisinin resistance. However, this should not undermine the need for continuous monitoring and surveillance of the response of P. falciparum to Artemisinin and Artemisinin combination therapy (ACTs) in River State.