Introduction The return of chloroquine-sensitive P. falciparum in sub-Saharan Africa countries offers the opportunity for reintroduction of chloroquine either in combination with other drugs or as a single therapy for the management of malaria. The reintroduction of chloroquine can serve as a stopgap to salvage the impending danger of complete failure of malaria treatment due to artemisinin drug resistance. Further, chloroquine reintroduction requires the understanding of the underlying factors that influence the reemergence of chloroquine-sensitive P. falciparum in the endemic areas. This study assesses the effects of age on the pattern for selection of CQ sensitive P. falciparum markers in the Central Region of Ghana Methodology Genomic DNA was extracted from an archived filter paper blood blot from Cape Coast, Elmina, Assin Foso and Twifo Praso using Chelex DNA extraction method. The age information to each extracted sample was collected. The prevalence of chloroquine-sensitive genotyping of Pfcrt K76 and Pfmdr1 N86 was assessed using nested PCR and RFLP. Results The overall prevalence of CQ sensitive P. falciparum marker (Pfcrt K76) at Central Region of Ghana was 66.36%, whereas the prevalence of Pfcrt K76 at Cape Coast, Assin Foso, Twifo Praso and Elmina were 71.74%, 65.22%, 66.67% and 61.54% respectively. The prevalence of Pfcrt K76 among the age categories showed that 0-5 years category predominantly selects CQ sensitive Pfcrt K76 marker at Cape Coast (34.76%), Assin Foso (37.68%) and Twifo Praso (39.98%). In the case of Pfmdr1 N86, the total prevalence was 84.11% with Cape Coast having 64%, Elmina with 92.26%, Assin Foso with 88.39% and Twifo Praso with 89.91% There was strong correlation of reemergence of chloroquine-sensitive malaria parasites between Cape Coast and Assin Foso, (r=0.8568, p=0.0318) Cape Coast and Twifo Praso (r=0.8671, p=0.0285) and Assin Foso and Twifo Praso, (r=0.9913, p=0.0005). Conclusion The study showed that the selection and expansion of chloroquine-sensitive P. falciparum are influenced by age and geographical area. This finding has a significant implication for the future treatment, management and control of P. falciparum malaria.
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