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Background   Plasmodium vivax  is the prevalent malarial species accounting for 70% of malaria burden in Pakistan; however, there is no baseline data on the circulating genotypes. Studies have shown that polymorphic loci of gene encoding antigens  pvcsp  and  pvmsp1  can be used reliably for conducting molecular epidemiological studies. Therefore, this study aimed to bridge the existing knowledge gap on population structure on  P .  vivax  from Pakistan using these two polymorphic genes.    Methods  During the period January 2008 to May 2009, a total of 250 blood samples were collected from patients tested slide positive for  P .  vivax , at the Aga Khan University Hospital, Karachi, or its collection units located in Baluchistan and Sindh Province. Nested PCR/RFLP was performed, using  pvcsp  and  pvmsp1  markers to detect the extent of genetic diversity in clinical isolates of  P .  vivax  from southern Pakistan.    Results  A total of 227/250 (91%) isolates were included in the analysis while the remainder were excluded due to negative PCR outcome for  P . vivax .  Pvcsp  analysis showed that both VK 210 (85.5%, 194/227) and VK 247 type (14.5%, 33/227) were found to be circulating in  P .  vivax  isolates from southern Pakistan. A total of sixteen and eighty-seven genotypes of  pvcsp  and  pvmsp - 1  were detected respectively.    Conclusion  This is the first report from southern Pakistan on characterization of  P .  vivax  isolates confirming that extensively diverse  pvcsp  and  pvmsp1  variants are present within this region. Results from this study provide valuable data on genetic diversity of  P .  vivax  that will be helpful for further epidemiological studies.

Genetic diversity of Plasmodium vivax clinical isolates from southern Pakistan using pvcsp and pvmsp1 genetic markers