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Case Report: A Case of Plasmodium falciparum hrp2 and hrp3 Gene Mutation in Bangladesh

Maisha Khair NimaInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;

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Thomas HougardInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;
Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, Minnesota;

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Mohammad Enayet HossainInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;

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Mohammad Golam KibriaInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;

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Abu Naser MohonInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;
Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta T2N1N4, Canada

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Fatema Tuj JohoraInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;

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Rajibur RahmanInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;

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Rashidul HaqueInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;

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Mohammad Shafiul AlamInternational Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh;

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Several species of Plasmodium are responsible for causing malaria in humans. Proper diagnoses are crucial to case management, because severity and treatment varies between species. Diagnoses can be made using rapid diagnostic tests (RDTs), which detect Plasmodium proteins. Plasmodium falciparum causes the most virulent cases of malaria, and P. falciparum histidine-rich protein 2 (PfHRP2) is a common target of falciparum malaria RDTs. Here we report a case in which a falciparum malaria patient in Bangladesh tested negative on PfHRP2-based RDTs. The negative results can be attributed to a deletion of part of the pfhrp2 gene and frameshift mutations in both pfhrp2 and pfhrp3 gene. This finding may have implications for malaria diagnostics and case management in Bangladesh and other regions of South Asia.

Author Notes

Address correspondence to Mohammad Shafiul Alam, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh. E-mail: shafiul@icddrb.org

Financial support: This study was funded by the Swiss Academy of Medical Science (SAMS) and the Velux Foundation.

Authors’ addresses: Maisha Khair Nima, Mohammad Enayet Hossain, Mohammad Golam Kibria, Fatema Tuj Johora, Rajibur Rahman, Rashidul Haque, and Mohammad Shafiul Alam, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh, E-mails: maisha.khair@icddrb.org, houga006@umn.edu, golam.kibria@icddrb.org, tomazooldu@gmail.com, rajibur.rahman@icddrb.org, rhaque@icddrb.org, and shafiul@icddrb.org. Thomas Hougard, Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN, E-mail: houga006@umn.edu. Abu Naser Mohon, Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta T2N1N4, Canada, E-mail: manmohon@ucalgary.ca.

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