Abstract. The present study was designed to investigate the genetic diversity of Plasmodium falciparum among field isolates from India. A total of 71 clinical isolates were analyzed by the polymerase chain reaction (PCR) for the amplification of repeat regions of malaria vaccine candidate antigen genes, i.e., merozoite surface antigen-1 (MSA-1), MSA-2, and circumsporozoite protein (CSP). All three genes showed variation; MSA-2 has the maximum number of 10 variant forms while MSA-1 and CSP had 8 and 6 variants, respectively. Some variant forms were more common than others among the clinical isolates. There were mixed alleles for each gene in several (27 of (Orissa) not only showed the maximum number of variant forms of each gene but also the maximum number of cases with mixed alleles compared with the non-hyperendemic regions (Madhya Pradesh and Rajasthan). The presence of such large numbers of P. falciparum strains in India should be taken into account in future malaria vaccine programs.Malaria currently remains uncontrolled despite immense efforts being made to contain the disease. The unavailability of a suitable malaria vaccine and emergence of drug-resistant parasites are further complicating the situation in tropical areas. Of the four species of human malaria parasites, Plasmodium falciparum is most lethal and causes epidemics in tropical countries. 1,2 Although several vaccine candidate antigens of P. falciparum have been identified and characterized, the availability of a universal malaria vaccine is still a remote possibility. One reason is the antigenic variation of different geographic isolates of the parasite. The most common and widely characterized vaccine candidate antigens are circumsporozoite protein (CSP) and merozoite surface antigens-1 and -2 (MSA-1 and MSA-1). Allelic forms of these antigen genes have been reported in the literature among several laboratory and wild type field isolates from different parts of the world. 3-8 However, there is limited information on the polymorphic nature of these genes among field isolates from India. Bhattacharya and others have shown only point mutations in MSA-2 gene among Indian laboratory and field isolates. 9,10 In contrast, we show in this report larger deletions/additions (detected by agarose gel electrophoresis) not only for the MSA-2 gene but also for MSA-1 and CSP genes among field isolates from hyperendemic and non-hyperendemic regions of India. The present study also shows an increase in the number of variants and mixed alleles with malaria hyperendemicity.
MATERIALS AND METHODSPatients and blood collection. Patients with fever attended malaria clinics at primary health centers (PHCs) or district hospitals. Fingerprick blood was examined for the presence of malarial parasites by light microscopy after Giemsa staining. Approximately 20 l of fingerprick blood was collected from those patients who were confirmed to be positive for the presence of P. falciparum parasites. These patients were informed in the local language about the nature of the expe...