Details

Autor(en) / Beteiligte

• Parr, Jonathan B.
• Kieto, Eddy
• Phanzu, Fernandine
• Mansiangi, Paul
• Mwandagalirwa, Kashamuka
• Mvuama, Nono
• Landela, Ange
• Atibu, Joseph
• Efundu, Solange Umesumbu
• Olenga, Jean W.
• Thwai, Kyaw Lay
• Morgan, Camille E.
• Denton, Madeline
• Poffley, Alison
• Juliano, Jonathan J.
• Mungala, Pomie
• Likwela, Joris L.
• Sompwe, Eric M.
• Rogier, Eric
• Tshefu, Antoinette K.
• N’Siala, Adrien
• Kalonji, Albert

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.