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Background  Imported malaria parasites with anti-malarial drug resistance (ADR) from Africa is a serious public health challenge in non-malarial regions, including Wuhan, China. It is crucial to assess the ADR status in African  Plasmodium falciparum  isolates from imported malaria cases, as this will provide valuable information for rational medication and malaria control.    Methods  During 2017–2019, a cross-sectional study was carried out in Wuhan, China. Peripheral blood 3 ml of returned migrant workers from Africa was collected. The target fragments from  pfcrt ,  pfmdr1 , and  k13 propeller  ( pfk13 ) genes were amplified, sequenced, and analysed.    Results  In total, 106 samples were collected. Subsequently, 98.11% (104/106), 100% (106/106), and 86.79% (92/106) of these samples were successfully amplified and sequenced for the  pfcrt  (72–76),  pfmdr1 , and  pfk13  genes, respectively. The prevalence of the  pfcrt  76  T ,  pfmdr1  86 Y , and  pfmdr1  184 F  mutations was 9.62, 4.72, and 47.17%, respectively. At codons 72–76, the  pfcrt  locus displayed three haplotypes, CVMNK (wild-type), CV IET  (mutation type), CV M/ I  N/ E  K/ T  (mixed type), with 87.50%, 9.62%, and 2.88% prevalence, respectively. For the  pfmdr1  gene, NY (wild type), N F  and  YF  (mutant type), N Y/ F , Y Y/ F , and N/ Y  Y/ F  (mixed type) accounted for 34.91, 43.40, 3.77, 15.09, 0.94, and 1.89% of the haplotypes, respectively. A total of 83 isolates with six unique haplotypes were found in  pfcrt  and  pfmdr1  combined haplotypes, of which NY-CVMNK and N F -CVMNK accounted for 40.96% (34/83) and 43.37% (36/83), respectively. Furthermore, 90 cases were successfully sequenced (84.91%, 90/106) at loci 93, 97, 101, and 145, and 78 cases were successfully sequenced (73.58%, 78/106) at loci 343, 353, and 356 for  pfcrt . However, the mutation was observed only in locus 356 with 6.41%. For  pfk13 , mutations reported in Southeast Asia (at loci 474, 476, 493, 508, 527, 533, 537, 539, 543, 553, 568, 574, 578, and 580) and Africa (at loci 550, 561, 575, 579, and 589) were not observed.    Conclusions  The present data from  pfcrt  and  pfmdr1  demonstrate that anti-malarial drugs including chloroquine, amodiaquine, and mefloquine, remain effective against malaria treatment in Africa. The new mutations in  pfcrt  related to piperaquine resistance remain at relatively low levels. Another source of concern is the artemether-lumefantrine resistance-related profiles of N86 and 184 F  of  pfmdr1 . Although no mutation in  pfk13  is detected, molecular surveillance must continue.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12936-021-03737-8.

malaria journal

Molecular surveillance of anti-malarial resistance pfcrt, pfmdr1, and pfk13 polymorphisms in African Plasmodium falciparum imported parasites to Wuhan, China