Prevalence of Plasmodium falciparum Infection and Anti-malarial Drug-resistance Genes in Individuals with Sickle Cell Disease in Jigawa State, Nigeria

Abstract

Malaria remains a significant cause of morbidity among individuals with sickle cell disease (SCD), despite routine antimalarial prophylaxis. This study assessed the prevalence of Plasmodium falciparum infection and the distribution of antimalarial drug-resistance genes among homozygous SCD (HbSS) patients attending Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria. A total of 186 HbSS individuals were enrolled. Malaria infection was diagnosed using rapid diagnostic tests and confirmed by microscopy, while parasite density was determined from thick blood smears. Molecular detection of resistance-associated genes (Pfmdr1, Pfk13, Pfdhps, Pfdhfr, and Pfcrt) was performed using a multiplex PCR. Overall malaria prevalence was 38.7%, with a geometric mean parasite density of 15,832 parasites/µL. Infection was most frequent among children aged 6–10 years, and no significant association was observed with sex or age. Despite high prophylaxis coverage, Pfdhps (66.6%) was the most prevalent resistance gene, while Pfcrt (6.9%) showed the lowest frequency. These findings highlight the persistence of malaria transmission and the circulation of resistance genes among SCD patients, underscoring the need for strengthened molecular surveillance and targeted malaria control strategies among this vulnerable population.