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Monitoring of anti-malarial drug resistance is vital in Northeast India as this region shares its international border with Southeast Asia. Genetic diversity of  Plasmodium  parasites regulates transmission dynamics, disease severity and vaccine efficacy.  P .  falciparum  chloroquine resistance transporter ( Pfcrt ), multidrug resistance-1 ( Pfmdr-1 ) and kelch 13 propeller ( PfK-13 ) genes which govern antimalarial drug resistance and three genetic diversity markers, merozoite surface protein 1 and 2 ( Pfmsp-1 ,  Pfmsp-2 ) and glutamate rich protein ( Pfglurp ) were evaluated from Tripura, Northeast India using molecular tools. In the  Pfcrt  gene, 87% isolates showed triple mutations at codons M74I, N75E and K76T. 12.5% isolates in  Pfmdr-1  gene showed mutation at N86Y. No polymorphism in  PfK-13 propeller  was found. Polyclonal infections were observed in 53.85% isolates and more commonly in adults (p = 0.0494). In the  Pfmsp-1  locus, the K1 allelic family was predominant (71.2%) followed by the 3D7/IC family (69.2%) in the  Pfmsp-2  locus. RII region of  Pfglurp  exhibited nine alleles with expected heterozygosity of 0.85. The multiplicity of infection for  Pfmsp-1 ,  Pfmsp-2  and  Pfglurp  were 1.56, 1.31 and 1.06 respectively. Overall, the study demonstrated a high level of chloroquine resistance and extensive parasite diversity in the region, necessitating regular surveillance in this population group.

Characterization of drug resistance and genetic diversity of Plasmodium falciparum parasites from Tripura, Northeast India