The genetic complexity of Plasmodium falciparum is contributory to the emergence of drug resistant-parasites. Intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in malaria endemic settings is recommended by WHO. This study evaluated the prevalence of Plasmodium falciparum multidrug resistance-1 gene (Pfmdr-1), genetic diversity of merozoite surface proteins (msp-1, msp-2) and glutamate-rich protein (glurp) among pregnant women with sub-patent parasitaemia from southwest Nigeria. One hundred PCR-confirmed Plasmodium falciparum isolates, collected at first visit-V-1 (n=52), delivery (n=31) and cord blood (n=17), were selected for analysis. The Pfmdr-1 alleles was evaluated using restriction fragment length polymorphism (RLFP), while msp-1, msp-2 and glurp genes were genotyped. Allelic frequency distribution and multiplicity of infection were calculated at p-value ≤0.05. The Pfmdr-1 (N86/N86Y) combination was detected in 11.8%, 61.3% and 58.8% (p≤0.05) in V-1, Delivery and Cord isolates respectively. The N86Y haplotype was detected only in cord (5.9%). The allelic frequency distribution for msp-1 was 244 (K1=81, MAD20=84 and RO33=79), and msp-2; 110 alleles, representing 43.6% (FC27) and 56.4% (3D7). While glurp expressed 25 alleles, 84% (V-1), 12% (delivery) and 4% (cord), respectively (p≤0.05). The msp-1 and msp-2 recorded higher MOIs than glurp. Genetically diverse P. falciparum strains with Pfmdr-1 mutant alleles were detected in pregnant women with sub-patent parasitaemia in southwest Nigeria, which may reduce IPTp-SP effectiveness. Thus, continuous molecular surveillance of resistant-parasites to sulphadoxine-pyrimethamine and ACTs is essential.
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