ArticleScientific reports2021
Analysis of false-negative rapid diagnostic tests for symptomatic malaria in the Democratic Republic of the Congo.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 43 citations in OpenAlex.
- Challenges in Malaria Diagnosis and Treatment in Kinshasa Province, Democratic Republic of the Congo.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Positive tests are all alike, every negative test is negative in its own way: lack of confidence in negative malaria rapid diagnostic tests in the Democratic Republic of the Congo.Malaria journal · 2026Article
- False-positive and false-negative malaria rapid diagnostic test results: evidence from a nationally representative survey of children in Ghana.Malaria journal · 2026Article
- Global risk of selection and spread of Plasmodium falciparum histidine-rich protein 2 and 3 gene deletions.Nature medicine · 2025Article
- Field evaluation of the Bioline Malaria Ag P.f/Pan rapid diagnostic test: causes of microscopy discordance and performance in Uganda.Malaria journal · 2025Article
- Population genomics of Plasmodium ovale species in sub-Saharan Africa.Nature communications · 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
- Population genomics ofbioRxiv : the preprint server for biology · 2024Article
- Development of new real-time PCR assays for detection and species differentiation of Plasmodium ovale.PLoS neglected tropical diseases · 2024Article
- Widespread pfhrp2/3 deletions and HRP2-based false-negative results in southern Ethiopia.Malaria journal · 2024Article
- Detection of P. malariae using a new rapid isothermal amplification lateral flow assay.Malaria journal · 2024Article
- Genomic insights into Plasmodium vivax population structure and diversity in central Africa.Malaria journal · 2024Article
- A novel duplex qualitative real-time PCR assay for the detection and differentiation of Plasmodium ovale curtisi and Plasmodium ovale wallikeri malaria.medRxiv : the preprint server for health sciences · 2023Article
- Epidemiology of Plasmodium malariae and Plasmodium ovale spp. in Kinshasa Province, Democratic Republic of Congo.Nature communications · 2023Article
- Plasmodium falciparum with pfhrp2/3 Deletion Not Detected in a 2018-2021 Malaria Longitudinal Cohort Study in Kinshasa Province, Democratic Republic of the Congo.The American journal of tropical medicine and hygiene · 2023Article
- Similar Prevalence of Plasmodium falciparum and Non-P. falciparum Malaria Infections among Schoolchildren, TanzaniaEmerging infectious diseases · 2023Article
- Plasmodium falciparum pfhrp2 and pfhrp3 Gene Deletions and Relatedness to Other Global Isolates, Djibouti, 2019-2020.Emerging infectious diseases · 2022Article
- Factors Affecting the Performance of HRP2-Based Malaria Rapid Diagnostic Tests.Tropical medicine and infectious disease · 2022Review
- Screening strategies and laboratory assays to support Plasmodium falciparum histidine-rich protein deletion surveillance: where we are and what is needed.Malaria journal · 2022Review
- Low prevalence of Plasmodium falciparum parasites lacking pfhrp2/3 genes among asymptomatic and symptomatic school-age children in Kinshasa, Democratic Republic of Congo.Malaria journal · 2022Article
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22 authors at 6 institutions in 3 countries.
Funding
Abstract
The majority of Plasmodium falciparum malaria diagnoses in Africa are made using rapid diagnostic tests (RDTs) that detect histidine-rich protein 2. Increasing reports of false-negative RDT results due to parasites with deletions of the pfhrp2 and/or pfhrp3 genes (pfhrp2/3) raise concern about existing malaria diagnostic strategies. We previously identified pfhrp2-negative parasites among asymptomatic children in the Democratic Republic of the Congo (DRC), but their impact on diagnosis of symptomatic malaria is unknown. We performed a cross-sectional study of false-negative RDTs in symptomatic subjects in 2017. Parasites were characterized by microscopy; RDT; pfhrp2/3 genotyping and species-specific PCR assays; a bead-based immunoassay for Plasmodium antigens; and/or whole-genome sequencing. Among 3627 symptomatic subjects, 427 (11.8%) had RDT-/microscopy + results. Parasites from eight (0.2%) samples were initially classified as putative pfhrp2/3 deletions by PCR, but antigen testing and whole-genome sequencing confirmed the presence of intact genes. 56.8% of subjects had PCR-confirmed malaria. Non-falciparum co-infection with P. falciparum was common (13.2%). Agreement between PCR and HRP2-based RDTs was satisfactory (Cohen's kappa = 0.66) and superior to microscopy (0.33). Symptomatic malaria due to pfhrp2/3-deleted P. falciparum was not observed. Ongoing HRP2-based RDT use is appropriate for the detection of falciparum malaria in the DRC.
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