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Background  The genetic diversity of  Plasmodium falciparum  allows the molecular discrimination of otherwise microscopically identical parasites and the identification of individual clones in multiple infections. The study reported here investigated the  P. falciparum  multiplicity of infection (MOI) and genetic diversity among school-aged children in the Man region, western Côte d’Ivoire.    Methods  Blood samples from 292 children aged seven to 15 years were collected in four nearby villages located at altitudes ranging from 340 to 883 m above sea level. Giemsa-stained thick and thin blood films were prepared and examined under a microscope for  P. falciparum  prevalence and parasitaemia. MOI and genetic diversity of the parasite populations were investigated using  msp2  typing by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).    Results   Plasmodium falciparum  prevalence and parasitaemia were both found to be significantly lower in the highest altitude village. Genotyping of the isolates revealed 25 potentially new  msp2  alleles. MOI varied significantly across villages but did not correlate with altitude nor children’s age, and only to a limited extent with parasitaemia. An analysis of molecular variance (AMOVA) indicated that a small, but close to statistical significance ( p  = 0.07), fraction of variance occurs specifically between villages of low and high altitudes.    Conclusions  Higher altitude was associated with lower prevalence of  P. falciparum  but not with reduced MOI, suggesting that, in this setting, MOI is not a good proxy for transmission. The evidence for partially parted parasite populations suggests the existence of local geographical barriers that should be taken into account when deploying anti-malarial interventions.

Genetic diversity of Plasmodium falciparum among school-aged children from the Man region, western Côte d’Ivoire