ArticleBMC infectious diseases2024
Histidine-rich protein (hrp) 2-based RDT false-negatives and Plasmodium falciparum hrp 2 and 3 gene deletions in low, seasonal and intense perennial transmission zones in Cameroon: a cross - sectional study.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Burden and clinical impact of 'neglected' transfusion-transmitted infections in Cameroon: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2026Pooled it
- Diagnostic challenges in malaria detection: A comparative diagnostic performance of HRP2-based rapid diagnostic tests, microscopy, and PCR at Bichena primary hospital, Northwest Ethiopia.Parasite epidemiology and control · 2026Article
- Evaluation of malaria rapid diagnostic test kit performance in a high-transmission setting: a facility-based cross-sectional study in rural Ghana.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
- Ultrasensitive ELISA for Accurate Detection ofOpen forum infectious diseases · 2025Article
- Epidemiology of ovale, vivax and falciparum malaria in the highlands of Cameroon: An integrated community survey of human infection and vector abundance.PLoS neglected tropical diseases · 2025Article
- Malaria infection prevalence and diagnostic performance of the Abbott Bioline Malaria Ag P.f/Pan rapid test in rural populations of Central Cameroon.Scientific reports · 2025Article
- Article
- Epidemiology of Relapsing and Falciparum Malaria in the Highlands of Cameroon: An Integrated Community Survey of Human Infection and Vector Abundance.medRxiv : the preprint server for health sciences · 2025Article
- Exploring Biomarkers for Malaria: Advances in Early Detection and Asymptomatic Diagnosis.Biosensors · 2025Review
- Diagnostic accuracy ofExperimental biology and medicine (Maywood, N.J.) · 2025Article
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Abstract
backgroundFalse negative rapid diagnostic tests (RDTs) accruing to the non-detection of Plasmodium falciparum histidine-rich protein 2/3 (Pfhrp2/3) is threatening the diagnosis and management of malaria. Although regular monitoring is necessary to gauge the level of efficacy of the tool, studies in Cameroon remain limited. This study assessed Plasmodium spp. prevalence and Pfhrp2/3 gene deletions across ecological and transmission zones in Cameroon.
methodsThis is a cross-sectional, multi-site, community- and hospital- based study, in 21 health facilities and 14 communities covering all five ecological settings in low seasonal (LS) and intense perennial (IPT) malaria transmission zones between 2019 and 2021. Participants were screened for malaria parasite using Pfhrp2 RDT and light microscopic examination of thick peripheral blood smears. DNA was extracted from dried blood spot using chelex
resultsA total of 3,373 participants enrolled, 1,786 Plasmodium spp. infected, with 77.4% P. falciparum. Discordant RDT and qPCR results (False negatives) were reported in 191 (15.7%) P. falciparum mono-infected samples from LS (29%, 42) and IPT (13.9%, 149). The Pfhrp2+/Pfhrp3 + genotype was most frequent, similar between LS (5.5%, 8/145) and IPT (6.0%, 65/1,076). Single Pfhrp2 and Pfhrp3 gene deletions occurred in LS (0.7%, 1/145 each) and IPT (3.6%, 39/1,076 vs. 2.9%, 31/1,076), respectively. Whilst a single sample harboured Pfhrp2-/Pfhrp3- genotype in LS, 2.4% (26/1,076) were double deleted at IPT. Pfhrp2+/Pfhrp3- (0.3%, 3/1,076) and Pfhrp2-/Pfhrp3+ (1.2%, 13/1,076) genotypes were only observed in IPT. Pfhrp2, Pfhrp3 deletions and Pfhrp2-/Pfhrp3- genotype accounted for 78.8% (26), 69.7% (23) and 63.6% (21) RDT false negatives, respectively.
conclusionPlasmodium falciparum remains the most dominant and widely distributed Plasmodium species across transmission and ecological zones in Cameroon. Although the low prevalence of Pfhrp2/3 gene deletions supports the continued use of HRP2-based RDTs for routine malaria diagnosis, the high proportion of false-negatives due to gene deleted parasites necessitates continued surveillance to inform control and elimination efforts.
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