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Antimalarial drug resistance is a major public health problem in China. From 2012 to 2015, more than 75% of malaria cases in Shandong Province were  P .  falciparum  returned from Africa. However, molecular marker polymorphisms of drug resistance in imported  P .  falciparum  cases have not been evaluated. In this study, we analyzed polymorphisms of the  Pfcrt ,  Pfmdr1 , and  Pfkelch13  genes in 282  P .  falciparum  cases returned from Africa to Shandong between 2012 and 2015. Among the isolates, polymorphisms were detected in codons 74–76 of  Pfcrt  and 86, 184, 1246 of  Pfmdr1 , among which K76T (36.6%) and Y184F (60.7%) were the most prevalent, respectively. Six  Pfcrt  haplotypes and 11  Pfmdr1  haplotypes were identified and a comparison was made on the prevalence of haplotypes among East Africa, West Africa, Central Africa and South Africa. One synonymous and 9 nonsynonymous mutations in  Pfkelch13  were detected in the isolates (4.6%), among which a candidate artemisinin (ART) resistance mutation P553L was observed. The study establishes fundamental data for detection of chloroquine resistance (CQR) and ART resistance with molecular markers of the imported  P .  falciparum  in China, and it also enriches the genetic data of antimalarial resistance for the malaria endemic countries in Africa.

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Surveillance of Antimalarial Resistance Pfcrt, Pfmdr1, and Pfkelch13 Polymorphisms in African Plasmodium falciparum imported to Shandong Province, China