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Malaria remains a public health problem in Thailand, especially along its borders where highly mobile populations can contribute to persistent transmission. This study aimed to determine resistant genotypes and phenotypes of 112  Plasmodium falciparum  isolates from patients along the Thai-Cambodia border during 2013–2015. The majority of parasites harbored a  pfmdr1 -Y184F mutation. A single  pfmdr1  copy number had CVIET haplotype of amino acids 72–76 of  pfcrt  and no  pfcytb  mutations. All isolates had a single  pfk13  point mutation (R539T, R539I, or C580Y), and increased % survival in the ring-stage survival assay (except for R539I). Multiple copies of  pfpm2  and  pfcrt -F145I were detected in 2014 (12.8%) and increased to 30.4% in 2015. Parasites containing either multiple  pfpm2  copies with and without  pfcrt -F145I or a single  pfpm2  copy with  pfcrt -F145I exhibited elevated IC 90  values of piperaquine. Collectively, the emergence of these resistance patterns in Thailand near Cambodia border mirrored the reports of dihydroartemisinin-piperaquine treatment failures in the adjacent province of Cambodia, Oddar Meanchey, suggesting a migration of parasites across the border. As malaria elimination efforts ramp up in Southeast Asia, host nations militaries and other groups in border regions need to coordinate the proposed interventions.

Plasmodium falciparum phenotypic and genotypic resistance profile during the emergence of Piperaquine resistance in Northeastern Thailand