Objective: To study the currently circulating dhfr and dhps haplotypes and assess the distribution of K-13 gene polymorphism in children under treatment with artemether-lumefantrine (AL) and artesunate-sulfadoxine-pyrimethamine (ASSP) in Bangui.

Methods: A single-blind randomized cross-sectional study was conducted from August 10 to November 30, 2024, in 135 children aged 6 months to 14 years who were cared for and followed up for simple malaria access at the pediatric hospital complex in Bangui. Five capillary blood spots were made on Whatman® filter paper for molecular analysis before treatments. The parasitic DNA was extracted using the QIAGEN®kit. Resistance markers dhfr, dhps, and Kelch 13 were analyzed by PCR.

Results: The dhfr-N51I-C59R-S108N-dhps-S436A mutants were predominant with a prevalence of 67.44%. For the dhfr gene, the triple mutant N51I-C59R-S108N was detected in 96.21% of cases, the double mutant C59R-S108N and N51I-N108N were detected with a prevalence of 0.76% and 3.03%, respectively. The mutant S436A of the dhps gene was found in 94 isolates, or 69.47%. The K13 gene polymorphism showed 09 mutants synonyms: P413P, C469C, E509E, V510V, E567E, S623S, G690G, P715P, V714V and 04 mutants non-synonyms: I416V, V650F, V520I/V637I.

Conclusion: This study shows that dhfr-N51I-C59R-S108N-dhps-S436A mutants are currently circulating in Bangui and that Plasmodia carrying synonymous and non-synonymous mutations have been detected at the paediatric and university complex of Bangui, hence the need to continue monitoring these resistance markers regularly.