Molecular markers of Plasmodium falciparum drug resistance in southern highland Rwanda

► Drug resistance markers were typed in Plasmodium falciparum from southern Rwanda. ► One of the worst degrees of antifolate drug resistance worldwide was observed. ► Pfmdr1 alleles suggest intense artemether-lumefantrine pressure on local parasites. ► Monitoring of artemether-lumefantrine efficacy and pfmdr1 alleles is warranted.