ArticleMalaria journal2016
Plasmodium falciparum histidine rich protein-2 diversity and the implications for PfHRP 2: based malaria rapid diagnostic tests in Ghana.
Article in Malaria journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 5 of them syntheses that pooled it.
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88 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Detection of asymptomatic malaria in Asian countries: a meta-analysis of diagnostic accuracy.Malaria journal · 2022Pooled it
- Plasmodium falciparum histidine-rich protein 2 and 3 genes deletion in global settings (2010-2021): a systematic review and meta-analysis.Malaria journal · 2022Pooled it
- Impact of Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions on malaria control worldwide: a systematic review and meta-analysis.Malaria journal · 2021Pooled it
- Prevalence ofBulletin of the World Health Organization · 2020Pooled it
- Prevalence of Plasmodium falciparum field isolates with deletions in histidine-rich protein 2 and 3 genes in context with sub-Saharan Africa and India: a systematic review and meta-analysis.Malaria journal · 2020Pooled it
- Trial
- Trial
- Absence of false negative RDT results due to pfhrp2 deletion among symptomatic malaria infections in Kenya: findings from the 2022 Kenya national longitudinal surveillance of pfhrp2/3 deletions.Malaria journal · 2026Article
- Local variability inMalariaWorld journal · 2026Article
- Spatial and genetic dynamics of Plasmodium falciparum histidine-rich protein2 in sub-Saharan Africa.PloS one · 2026Article
- Global risk of selection and spread of Plasmodium falciparum histidine-rich protein 2 and 3 gene deletions.Nature medicine · 2025Article
- Analysis of pfhrp2 and pfhrp3 gene deletions, and the structure and variability of PfHRP2 and PfHRP3 proteins: implications for the performance of malaria rapid diagnostic tests in Cubal, Angola.Malaria journal · 2025Article
- Deletion of target gene (histidine-rich protein 2/3) for Plasmodium falciparum rapid diagnostic tests in Amhara region, Ethiopia: a cross-sectional study.Malaria journal · 2025Article
- Impact of hepatitis B virus infection in patients with plasmodium parasites in selected health facilities in Accra, Ghana.BMC infectious diseases · 2025Article
- Plasmodium falciparum with pfhrp2 and pfhrp3 gene deletions in asymptomatic malaria infections in the Lake Victoria region, Kenya.Tropical medicine and health · 2024Article
- Performance of ParaHIT® HRP2-Based Rapid Diagnostic Test and Proportions of Plasmodium falciparum Histidine-Rich Protein 2/3 Gene Deletions in Togo.The American journal of tropical medicine and hygiene · 2024Article
- Prevalence and factors associated with malaria among children aged 6 months to 10 years in the Greater Accra Region of Ghana: a community-based cross-sectional survey.Malaria journal · 2024Article
- Comparison of three rapid diagnostic tests for Plasmodium falciparum diagnosis in Ghana.Malaria journal · 2024Article
- Novel Plasmodium falciparum histidine-rich protein 2/3 repeat type in Ethiopian malaria infection: does this affect performance of HRP2-based malaria RDT?Malaria journal · 2024Article
- Widespread pfhrp2/3 deletions and HRP2-based false-negative results in southern Ethiopia.Malaria journal · 2024Article
28 more citing papers are in PubMed but not listed here.
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Abstract
backgroundMalaria rapid diagnostic tests (RDTs) play a key role in malaria management and control. The PfHRP-2 based RDT is the most widely used RDT for malaria diagnosis in Ghana. Deletion of pfhrp2 in Plasmodium falciparum parasites affect the diagnostic accuracy of PfHRP-2 based RDT kits. Identifying the prevalence and distribution of P. falciparum parasites with deleted pfhrp2 is important for malaria control.
aimThe purpose of this study was to identify and confirm the prevalence of pfhrp2 deletant P. falciparum parasites circulating within different regions of Ghana.
methodsDNA was extracted from the membrane of spent CareStart™ PfHRP-2 RDT kits and dried filter paper blood blots using Chelex-100. Exon 2 of pfhrp2 and pfhrp3 genes were amplified by polymerase chain reaction (PCR), resolved by agarose gel electrophoresis and visualized under UV light.
resultsMicroscopic analysis of blood smears from samples that were PfHRP-2 RDT positive revealed a parasite prevalence of 54/114 (47.4 %) and 2/26 (7.7 %) in Accra and Cape Coast, respectively. PCR analysis increased parasite prevalence in the RDT positive samples to 94/114 (82.5 %) and 6/26 (23.1 %) in Accra and Cape Coast respectively. The exon 2 of the pfhrp2 gene was deleted in 18/54 (33.3 %) of the microscopy confirmed and 36.2 % (34/94) of the PCR confirmed RDT positive samples collected in Accra. No RDT sample, confirmed to contain parasites by either PCR or microscopy was negative by pfhrp2 exon 2 PCR in Cape Coast. A survey of an additional 558 DBS revealed that 22.4 % (46/205) and 40 % (44/110) of PCR positive samples in Accra and Cape Coast, respectively, lacked the exon 2 region of pfhrp2 and possibly the entire pfhrp2 gene.
conclusionsA high number of P. falciparum parasites, which lack pfhrp2 exon 2 gene have been identified in two communities in Ghana. Continuous nationwide monitoring of the prevalence of pfhrp2 deletant parasites would be essential to malaria control. The use of RDT kits that are effective at malaria diagnosis despite deletion of pfhrp2, such as the PfHRP-2/PfLDH combo RDT kit could enhance the diagnosis of clinical malaria in Ghana.
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