ArticleMalaria journal2020
Impact of Plasmodium falciparum gene deletions on malaria rapid diagnostic test performance.
Article in Malaria journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Performance and challenges of malaria rapid diagnostic tests in endemic regions of Africa.Scientific reports · 2025Pooled it
- Performance of rapid diagnostic tests for malaria diagnosis in Nigeria: a systematic review and meta-analysis.Malaria journal · 2025Pooled it
- The prognostic and diagnostic value of intraleukocytic malaria pigment in patients with severe falciparum malaria.Nature communications · 2022Pooled it
- Selection and validation of novel DNA aptamer panel co-specific toMolecular therapy. Nucleic acids · 2026Article
- C1QB-Mediated Immunopathology in a Murine Malaria Model: A Multi-Omics Validation for Diagnostic and Therapeutic Targeting.International journal of molecular sciences · 2026Article
- Evaluation of microscopy and first response™ malaria Ag PAN/Pf RDT compared to qPCR and hemoglobin levels in pregnant women at delivery in Busia County, Western Kenya.BMC infectious diseases · 2026Article
- Resurgence of malaria in Ethiopia: a national landscape analysis of systemic and operational gaps.Malaria journal · 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
- Remoscope: a label-free imaging cytometer for malaria diagnostics.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2025Article
- The Diagnostic Performance of a Sysmex XN-31 Automated Malaria Analyzer vs. Expert Microscopy.International journal of laboratory hematology · 2025Article
- Performance and usability evaluation of three LDH-based malaria rapid diagnostic tests in Kédougou, Senegal.Parasites & vectors · 2025Article
- Genomic Deletion of PfHRP2 and PfHRP3 in Plasmodium falciparum Strains, Ethiopia, 2009.Emerging infectious diseases · 2025Article
- Prevalence of Plasmodium falciparum parasites with pfhrp2 exon 2 gene deletion in symptomatic malaria patients across Ghana in 2021.Malaria journal · 2025Article
- Genetic Characterization of Plasmodium falciparum Histidine-Rich Protein 2 Deletions and Their Impact on Malaria Interventions in Odisha, India.The American journal of tropical medicine and hygiene · 2025Article
- Contrasting sequence polymorphism and structural basis patterns ofJournal of biosciences · 2025Article
- Prevalence of pfhrp2/pfhrp3 gene deletions among patients with Plasmodium falciparum malaria with false-negative in the HRP2-based rapid diagnostic test in Colombia.Memorias do Instituto Oswaldo Cruz · 2025Article
- Diagnostic accuracy ofExperimental biology and medicine (Maywood, N.J.) · 2025Article
- Performance and usability evaluation of three LDH-based malaria rapid diagnostic tests in Kédougou, Senegal.medRxiv : the preprint server for health sciences · 2024Article
- Analytical Sensitivity Analysis and Clinical Impact Modeling of Rapigen Rapid Diagnostic Tests for Malaria.The American journal of tropical medicine and hygiene · 2024Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundMalaria rapid diagnostic tests (RDTs) have greatly improved access to diagnosis in endemic countries. Most RDTs detect Plasmodium falciparum histidine-rich protein 2 (HRP2), but their sensitivity is seriously threatened by the emergence of pfhrp2-deleted parasites. RDTs detecting P. falciparum or pan-lactate dehydrogenase (Pf- or pan-LDH) provide alternatives. The objective of this study was to systematically assess the performance of malaria RDTs against well-characterized pfhrp2-deleted P. falciparum parasites.
methodsThirty-two RDTs were tested against 100 wild-type clinical isolates (200 parasites/µL), and 40 samples from 10 culture-adapted and clinical isolates of pfhrp2-deleted parasites. Wild-type and pfhrp2-deleted parasites had comparable Pf-LDH concentrations. Pf-LDH-detecting RDTs were also tested against 18 clinical isolates at higher density (2,000 parasites/µL) lacking both pfhrp2 and pfhrp3.
resultsRDT positivity against pfhrp2-deleted parasites was highest (> 94%) for the two pan-LDH-only RDTs. The positivity rate for the nine Pf-LDH-detecting RDTs varied widely, with similar median positivity between double-deleted (pfhrp2/3 negative; 63.9%) and single-deleted (pfhrp2-negative/pfhrp3-positive; 59.1%) parasites, both lower than against wild-type P. falciparum (93.8%). Median positivity for HRP2-detecting RDTs against 22 single-deleted parasites was 69.9 and 35.2% for HRP2-only and HRP2-combination RDTs, respectively, compared to 96.0 and 92.5% for wild-type parasites. Eight of nine Pf-LDH RDTs detected all clinical, double-deleted samples at 2,000 parasites/µL.
conclusionsThe pan-LDH-only RDTs evaluated performed well. Performance of Pf-LDH-detecting RDTs against wild-type P. falciparum does not necessarily predict performance against pfhrp2-deleted parasites. Furthermore, many, but not all HRP2-based RDTs, detect pfhrp2-negative/pfhrp3-positive samples, with implications for the HRP2-based RDT screening approach for detection and surveillance of HRP2-negative parasites.
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