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Background   Plasmodium vivax  is the most widely distributed malaria parasite, and its drug resistance poses unique challenges to malaria elimination. The Greater Mekong Subregion (GMS) is known as the global epicenter of multidrug resistance. Surveillance of molecular markers associated with drug resistance in this area will help to inform drug policy.    Methods  Dry blood spots from 58 patients out of 109 with  P. vivax  infection between 2017, December and 2019, March were obtained from Yingjiang County, Yunnan Province, along the China–Myanmar border.  Pvdhfr, Pvdhps, Pvmdr1  and  Pvcrt-o  were amplified and sequenced to assess gene mutations. The polymorphism and prevalence of these molecular markers were analyzed.    Results  Mutations in  Pvdhfr  at codons 57, 58, 61, 99 and 117 were detected in 27.59, 48.28, 27.59, 32.76 and 48.28% of the isolates, respectively. Single mutant haplotype (I 13 F 57 S 58 T 61  S  99 S 117 I 173 ) was the most frequent (29.31%, 17/58), followed by double mutant haplotype (20.69%, 12/58). Of three types of tandem repeat variations of  Pvdhfr , deletion type was the most common.  Pvdhps  showed a lower prevalence among mutation genotypes. Single mutant was dominant and accounted for 34.48% (20/58). Prevalence of  Pvmdr1  mutations at codons 958 and 1076 were 100.00% and 84.48%, respectively. The proportion of double and single mutant types was 84.48% (49/58) and 15.52% (9/58), respectively. Eleven samples (18.97%, 11/58) showed K10 “AAG” insertion in chloroquine resistance transporter gene  Pvcrt-o .    Conclusions  There was moderate diversity of molecular patterns of resistance markers of  Pvdhfr ,  Pvdhps ,  Pvmdr1  and  Pvcrt-o  in imported  P. vivax  cases to Yingjiang county in Western Yunnan, along the China–Myanmar border. Prevalence and molecular pattern of candidate drug resistance markers  Pvdhfr ,  Pvdhps ,  Pvmdr1  and  Pvcrt-o  were demonstrated in this current study, which would help to update drug policy.

Prevalence of molecular markers associated with drug resistance of Plasmodium vivax isolates in Western Yunnan Province, China