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Plasmodium falciparum with pfhrp2/3 deletion not detected in a 2018-2021 malaria longitudinal cohort study in Kinshasa Province, Democratic Republic of the Congo

Francois, R.; Kashamuka, M. M.; Banek, K.; Bala, J. A.; Nkalani, M.; Kihuma, G.; Atibu, J.; Mahilu, G. E.; Thwai, K. L.; Assefa, A.; Bailey, J. A.; Dinglasan, R. R.; Juliano, J. J.; Tshefu, A.; Parr, J. B.

2022-11-18 public and global health
10.1101/2022.11.16.22282427 medRxiv
Show abstract

Histidine-rich protein 2- (HRP2-) based rapid diagnostic tests (RDTs) are widely used to detect Plasmodium falciparum in sub-Saharan Africa. Reports of parasites with pfhrp2 and/or pfhrp3 (pfhrp2/3) gene deletions in Africa raise concerns about the long-term viability of HRP2-based RDTs. We evaluated changes in pfhrp2/3 deletion prevalence over time using a 2018-2021 longitudinal study of 1,635 enrolled individuals in Kinshasa Province, Democratic Republic of the Congo (DRC). Samples collected during biannual household visits with [≥] 100 parasites/L by quantitative real-time PCR were genotyped using a multiplex real-time PCR assay. Among 2,726 P. falciparum PCR-positive samples collected from 993 participants during the study period, 1,267 (46.5%) were genotyped. No pfhrp2/3 deletions or mixed pfhrp2/3-intact and -deleted infections were identified in our study. Pfhrp2/3-deleted parasites were not detected in Kinshasa Province; ongoing use of HRP2-based RDTs is appropriate.

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