ArticleNature medicine2025
Global risk of selection and spread of Plasmodium falciparum histidine-rich protein 2 and 3 gene deletions.
Article in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Comparative permissiveness of Anopheles stephensi colony mosquito with an Anopheles arabiensis colony to Plasmodium falciparum gametocytes in Metehara, Ethiopia.Parasites & vectors · 2026Article
- 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
- World Malaria Day 2026: Driven to End Malaria.China CDC weekly · 2026Article
- Prevalence of Plasmodium falciparum histidine rich protein 2/3 gene deletions affecting rapid diagnostic test performance in travellers.Journal of travel medicine · 2026Article
- Malaria in Bangladesh, 2000-2025: Navigating the Headwinds From Control to Elimination.Health science reports · 2026Article
- Malaria control and the unexpected spread of diagnostic-resistantbioRxiv : the preprint server for biology · 2026Article
- Molecular, Transcriptomic, and Proteomic Characterization ofmedRxiv : the preprint server for health sciences · 2026Article
- False-positive and false-negative malaria rapid diagnostic test results: evidence from a nationally representative survey of children in Ghana.Malaria journal · 2026Article
- Low prevalence ofFrontiers in epidemiology · 2026Article
- Evaluation ofiScience · 2025Article
- Article
- Utility of rapid diagnostic tests and microscopy to detect malaria in health facilities across the Solomon Islands.Malaria journal · 2025Article
- Estimating malaria antigen dynamics and the time to negativity of next-generation malaria rapid diagnostic tests.Malaria journal · 2025Article
- Assessment of Malaria Rapid Diagnostic Tests and Histidine-Rich Protein 2 Deletions among Asymptomatic Children and Adults in Bagamoyo, Tanzania.The American journal of tropical medicine and hygiene · 2025Article
- Towards next-generation treatment options to combat Plasmodium falciparum malaria.Nature reviews. Microbiology · 2025Review
- Article
- Performance and usability evaluation of three LDH-based malaria rapid diagnostic tests in Kédougou, Senegal.medRxiv : the preprint server for health sciences · 2024Article
- Geospatial Analysis of Malaria Burden in Kagera Region, Northwestern Tanzania Using Health Facility and Community Survey Data.Open forum infectious diseases · 2024Article
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19 authors.
Funding
Abstract
Since their first detection in 2010, Plasmodium falciparum malaria parasites lacking the P. falciparum histidine-rich protein 2 gene (pfhrp2) have been observed in 40 of 47 surveyed countries, as documented by the World Health Organization. These genetic deletions reduce detection by the most widely used rapid diagnostic tests, prompting three countries to switch to alternative diagnostics. However, manufacturing of alternative rapid diagnostic tests has not been scaled up and there are no World Health Organization-prequalified combination tests that use P. falciparum Plasmodium lactate dehydrogenase. The continuing spread of pfhrp2 and/or pfhrp3 (pfhrp2/3) deletions threatens malaria control, creating an emerging public health crisis. Here we use mathematical modeling informed by current pfhrp2/3 deletion prevalence and a literature review to assess the global risk of pfhrp2/3 deletions. We identify ten priority countries for surveillance and predict that the primary spread in Africa will move southward from the Horn of Africa through East Africa within 20 years. Despite variation in modeled timelines due to uncertainty in model parameters, four countries yet to switch rapid diagnostic tests are consistently classified as high risk under a range of model assumptions. This updated model offers refined predictions to guide pfhrp2/3 policy and prioritize future surveillance efforts and innovation.
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