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The Search for Plasmodium falciparum histidine–rich protein 2/3 Deletions in Zambia and Implications for Plasmodium falciparum histidine-rich protein 2-Based Rapid Diagnostic Tests
We attempted to identify Plasmodium falciparum histidine–rich protein 2/3 (pfhrp2/3) deletions among rapid diagnostic test (RDT)–negative but PCR- or microscopy-positive P. falciparum–infected individuals in areas of low transmission (Choma District, 2009–2011) and high transmission (Nchelenge District, 2015–2017) in Zambia. Through community-based surveys, 5,167 participants were screened at 1,147 households by P. falciparum histidine-rich protein 2 (PfHRP2)-based RDTs. Slides were made and dried blood spots were obtained for molecular analysis. Of 28 samples with detectable P. falciparum DNA, none from Nchelenge District were pfhrp2/3 negative. All eight samples from Choma District had detectable pfhrp3 genes, but pfhrp2 was undetectable in three. DNA concentrations of pfhrp2-negative samples were low (< 0.001 ng/μL). These findings suggest that PfHRP2-based RDTs remain effective tools for malaria diagnosis in Nchelenge District, but further study is warranted to understand the potential for pfhrp2/3 deletions in southern Zambia where malaria transmission declined over the past decade.
Author Notes
Authors’ addresses: Tamaki Kobayashi, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: tkobaya2@jhu.edu. Jay Sikalima, Mike Chaponda, and Modest Mulenga, Tropical Diseases Research Centre, Ndola, Zambia, E-mails: sikalimaj@tdrc.org.zm, chapondam@tdrc.org.zm, and mulengam@tdrc.org.zm. Jonathan B. Parr, Division of Infectious Diseases, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, E-mail: jonathan_parr@med.unc.edu. Jennifer C. Stevenson and Philip E. Thuma, Macha Research Trust, Choma, Zambia, E-mails: jennyc.stevenson@macharesearch.org and phil.thuma@macharesearch.org.Steven R. Meshnick, Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC, E-mail: meshnick@email.unc.edu. William J. Moss, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: wmoss1@jhu.edu.
The Southern and Central Africa International Centers of Excellence for Malaria Research includes Biomedical Research and Training Institute, Zimbabwe; Johns Hopkins Malaria Research Institute, USA; Macha Research Trust, Zambia; National Institute of Health Research, Zimbabwe; Tropical Diseases Research Centre, Zambia; University of the Witwatersrand, South Africa; and Université Protestante au Congo.