Volume 100, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We attempted to identify histidine–rich protein 2/3 () deletions among rapid diagnostic test (RDT)–negative but PCR- or microscopy-positive –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 histidine-rich protein 2 (PfHRP2)-based RDTs. Slides were made and dried blood spots were obtained for molecular analysis. Of 28 samples with detectable DNA, none from Nchelenge District were negative. All eight samples from Choma District had detectable genes, but was undetectable in three. DNA concentrations of -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 deletions in southern Zambia where malaria transmission declined over the past decade.


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  • Received : 25 Oct 2018
  • Accepted : 30 Nov 2018
  • Published online : 04 Feb 2019

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