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Autor(en) / Beteiligte
Titel
Analysis of false-negative rapid diagnostic tests for symptomatic malaria in the Democratic Republic of the Congo
Ist Teil von
  • Scientific reports, 2021-03, Vol.11 (1), p.6495-6495, Article 6495
Ort / Verlag
London: Nature Publishing Group UK
Erscheinungsjahr
2021
Quelle
EZB Electronic Journals Library
Beschreibungen/Notizen
  • 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.
Sprache
Englisch
Identifikatoren
ISSN: 2045-2322
eISSN: 2045-2322
DOI: 10.1038/s41598-021-85913-z
Titel-ID: cdi_doaj_primary_oai_doaj_org_article_69b1915c79934da1b83f83083b3f0a84

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