DEVELOPMENT OF A MULTI-LABEL CLASSIFIER FOR PREDICTING GENETIC MARKERS ASSOCIATED WITH MULTI-DRUG RESISTANCE IN Plasmodium falciparum STRAINS

Abstract

Malaria is an infectious disease of global health importance caused by Plasmodium falciparum. It is highly complicated by parasite’s ability to gain resistance to multiple antimalarial drugs simultaneously, a phenomenon known as multidrug resistance (MDR). Single-label models only predict resistance to one drug at a time and as such would not capture these complex resistance patterns, limiting their utility for real-world surveillance. To bridge this gap, this study developed and evaluated four advanced multi-label classification models: Random Forest with Binary Relevance (RFDTBR), Ensemble of Classifier Chains (ECCJ48), Ensemble of Binary Relevance (EBRJ48), and a Backpropagation Neural Network (BPNN), using genomic and phenotypic data for five key antimalarials. Notably, RFDTBR and EBRJ48 outperformed others in predicting exact MDR profiles, while BPNN performed faster compared to the other models. Sulfadoxine-Pyrimethamine had the lowest performance across the models. Specific genomic features consistently emerged as key predictive factors across all models. These findings demonstrate the value of multi-label learning for comprehensive MDR prediction. Also, effective models and genomic regions were identified, warranting further investigation, thereby paving the way for improved resistance surveillance