Abstract
The mass migration that occurred during 2009–2013 and after the insurgency in northeastern Nigeria could have increased malaria incidence and Plasmodium falciparum genetic diversity in North Central Nigeria. To determine P. falciparum sequence diversity in this region, we screened 282 samples collected in regional clinics during 2015–2018 for Plasmodium spp. and, with positive samples, determined P. falciparum infection complexity and allele diversity using PCR. Of 34 P. falciparum–positive samples, 39 msp1, 31 msp2, and 13 glurp alleles were detected, and 88% of infections were polyclonal. We identified trimorphic and dimorphic allele combinations in a high percentage of samples, indicative of a high infection complexity in the study population. High genetic diversity is a catalyst for the evolution of drug-resistant alleles. Improved measures (e.g., better drug quality, diagnostics) are needed to control P. falciparum transmission and reduce the potential for the emergence of drug resistance in Nigeria.
Highlights
The mass migration that occurred during 2009–2013 and after the insurgency in northeastern Nigeria could have increased malaria incidence and Plasmodium falciparum genetic diversity in North Central Nigeria
The estimated prevalence of 37% for non–P. falciparum malaria species can probably be attributed to the circulation of >2% of the other Plasmodium species that infect humans
The increased transmission during this period can be explained by the open gutter and sewage systems present in urban areas of Nigeria; this factor has led to the mosquitoes that potentiate malaria transmission being prevalent year-round. In this prospective cross-sectional study, we investigated P. falciparum genetic diversity and the complexity of P. falciparum infection in North Central Nigeria because a high level of genetic diversity and infection complexity was a likely aftermath of the influx of IDPs into the region
Summary
The mass migration that occurred during 2009–2013 and after the insurgency in northeastern Nigeria could have increased malaria incidence and Plasmodium falciparum genetic diversity in North Central Nigeria. Health practitioners and professionals in Nigeria have determined that the failure to clear parasites and resolve clinical disease after drug treatment is the result of many factors (drug nonpotency, incorrect diagnosis, noncompliance with dosing regimen duration, use of substandard drugs, and drug interactions). These reports spurred us to investigate the complexity of P. falciparum infections and P. falciparum genetic diversity (allele frequencies) in the North Central region of Nigeria
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