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Background  Sulfadoxine-pyrimethamine (SP) combination drug is currently being used in India for the treatment of  Plasmodium falciparum  as partner drug in artemisinin-based combination therapy (ACT). Resistance to sulfadoxine and pyrimethamine in  P. falciparum  is linked with mutations in dihydropteroate synthase ( pfdhps ) and dihydrofolate reductase ( pfdhfr ) genes respectively. This study was undertaken to estimate the prevalence of such mutations in  pfdhfr  and  pfdhps  genes in four states of India.    Methods   Plasmodium falciparum  isolates were collected from two states of India with high malaria incidence i.e., Jharkhand and Odisha and two states with low malaria incidence i.e., Andhra Pradesh and Uttar Pradesh between years 2006 to 2012. Part of sulfadoxine-pyrimethamine (SP) drug resistance genes,  pfdhfr  and  pfdhps  were PCR-amplified, sequenced and analyzed.    Results  A total of 217 confirmed  P. falciparum  isolates were sequenced for both  Pfdhfr  and  pfdhps  gene. Two  pfdhfr  mutations 59R and 108N were most common mutations prevalent in all localities in 77 % of isolates. Additionally, I164L was found in Odisha and Jharkhand only (4/70 and 8/84, respectively). Another mutation 51I was found in Odisha only (3/70). The  pfdhps  mutations 436A, 437G, 540E and 581G were found in Jharkhand and Odisha only in 13, 26, 14 and 13 % isolates respectively, and was absent in Uttar Pradesh and Andhra Pradesh. Combined together for  pfdhps  and  pfdhfr  locus, triple, quadruple, quintuple and sextuple mutations were present in Jharkhand and Odisha while absent in Uttar Pradesh and Andhra Pradesh.    Conclusion  While only double mutants of  pfdhfr  was present in low transmission area (Uttar Pradesh and Andhra Pradesh) with total absence of  pfdhps  mutants, up to sextuple mutations were present in high transmission areas (Odisha and Jharkhand) for both the genes combined. Presence of multiple mutations in  pfdhfr  and  pfdhps  genes linked to SP resistance in high transmission area may lead to fixation of multiple mutations in presence of high drug pressure and high recombination rate.    Electronic supplementary material  The online version of this article (doi:10.1186/s13071-015-1080-2) contains supplementary material, which is available to authorized users.

Polymorphism in drug resistance genes dihydrofolate reductase and dihydropteroate synthase in Plasmodium falciparum in some states of India