In Ghana, malaria is still one of the top five morbidities at various health facilities. Majority of cases of malaria is caused by the parasite, Plasmodium falciparum. A minority of cases are caused either by P. malariae or P. ovale.

Current treatment options for malaria are targeted against falciparum malaria. It is important to know whether P. malariae and P. ovale are expanding in population in Ghana to inform modification of such cases in endemic areas. Previous studies in Ghana identified various frequencies of drug resistant P. falciparum strains in the Greater Accra region of Ghana. Notable among them were CVIET haplotypes in the Pfcrt gene, triple mutant haplotype (YFN) in the in Pfmdr1 gene, triple mutation resulting in IRNI haplotype in the Pfdhfr gene, quintuple mutation resulting in AGESS haplotype in the Pfdhps gene and various Kelch 13 mutations, namely, C580Y, P615L, A578S, I543V and A676S. These haplotypes were detected in asymptomatic adults. In clinical malaria cases in the same region, five Kelch 13 mutant genes were identified (F446I, S466N, R539I, A578S, and A676S) and three Pfmdr1 mutations (N86Y, Y184F and D1246Y). It appears that chloroquine resistant genes are shrinking while several artemisinin resistant genes are emerging.

In the previous studies, the sample sizes were too small to assess the real situation in Ghana. Therefore, this study shall assess the prevalence of chloroquine sensitive genes (as a measure of effect of reduced pressure of chloroquine on the parasite), with particular interest in the Eastern region of Ghana, assess the extent on emergence of putative artemisinin resistant genes, describe proportions of malaria attributable to P. falciparum, P. malariae or P. ovale or any other species. Additionally, the intensity of malaria transmission in these regions shall be assessed.