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Background   Plasmodium falciparum  parasites are known to exhibit extensive genetic diversity in areas of high transmission intensity and infected individuals in such communities often harbour several complex mixtures of parasite clones with different genetic characteristics. However, in the micro-environment, the extent of genetic diversity of  P. falciparum  parasites remain largely unknown. In this study therefore, the complexity of  P. falciparum  infections in households was investigated among symptomatic siblings, living under the same roof in north-central Nigeria.    Methods  Children were enrolled into the study if they were at least two from a household and presented with symptoms of uncomplicated malaria. Clinical malaria was confirmed by light microscopy of Giemsa-stained thick and thin blood films. Genomic DNA was isolated from blood spots on filter paper. Molecular characterization of  P. falciparum  isolates was done by allele-specific nested PCR of the highly polymorphic merozoite surface protein-2 ( msp-2 ) gene.    Results  Ninety-three children from 43 households were enrolled into this study. A total of 26 different  msp-2  alleles were identified from 215 fragments (range: 180–480 bp). Majority of the isolates [65.6% (n = 61)] were polyclonal infections consisting of 2–6 clones and were significantly more common with the FC27 allelic family ( p  = 0.036). The multiplicity of infection (MOI) per household ranged from 1.0 to 4.5 while the overall MOI in the study population was 2.31. The pattern of distribution of  msp-2  allele types among the households fell into two categories: households where both  msp-2  allele types (FC27 and 3D7) were present; households where only one  msp-2  allele type (FC27 or 3D7) was present. Majority of the households [88.4% (n = 38)], had both  msp-2  allele types but they were disproportionately distributed among the children while in a few households [11.6% (n = 5)], all the children were infected with only one type of  msp-2  allele.    Conclusion  These findings showed that  P. falciparum  isolates exhibit remarkable degree of genetic diversity in the micro-environment and are composed mainly of multiclonal infections, which is an indication of a high ongoing parasite transmission. This suggests that the micro-environment is an important area of focus for malaria control interventions and for evaluating intervention programmes.

malaria journal

Genetic diversity and complexity of Plasmodium falciparum infections in the microenvironment among siblings of the same household in North-Central Nigeria