Molecular surveillance reveals the presence of pfhrp2 and pfhrp3 gene deletions in Plasmodium falciparum parasite popula
- PDF / 2,174,678 Bytes
- 14 Pages / 595.276 x 790.866 pts Page_size
- 12 Downloads / 198 Views
Malaria Journal Open Access
RESEARCH
Molecular surveillance reveals the presence of pfhrp2 and pfhrp3 gene deletions in Plasmodium falciparum parasite populations in Uganda, 2017–2019 Agaba B. Bosco1,2* , Karen Anderson3,4, Karryn Gresty3,4, Christiane Prosser4, David Smith3,4, Joaniter I. Nankabirwa1,5, Sam Nsobya1,5, Adoke Yeka1,5, Jimmy Opigo2, Samuel Gonahasa5, Rhoda Namubiru1, Emmanuel Arinaitwe5, Paul Mbaka6, John Kissa7, Sungho Won8, Bora Lee8, Chae Seung Lim9, Charles Karamagi1, Jane Cunningham10, Joan K. Nakayaga1, Moses R. Kamya1,5 and Qin Cheng3,4
Abstract Background: Histidine-rich protein-2 (HRP2)-based rapid diagnostic tests (RDTs) are the only RDTs recommended for malaria diagnosis in Uganda. However, the emergence of Plasmodium falciparum histidine rich protein 2 and 3 (pfhrp2 and pfhrp3) gene deletions threatens their usefulness as malaria diagnostic and surveillance tools. The pfhrp2 and pfhrp3 gene deletions surveillance was conducted in P. falciparum parasite populations in Uganda. Methods: Three-hundred (n = 300) P. falciparum isolates collected from cross-sectional malaria surveys in symptomatic individuals in 48 districts of eastern and western Uganda were analysed for the presence of pfhrp2 and pfhrp3 genes. Presence of parasite DNA was confirmed by PCR amplification of the 18s rRNA gene, msp1 and msp2 single copy genes. Presence or absence of deletions was confirmed by amplification of exon1 and exon2 of pfhrp2 and pfhrp3 using gene specific PCR. Results: Overall, pfhrp2 and pfhrp3 gene deletions were detected in 29/300 (9.7%, 95% CI 6.6–13.6%) parasite isolates. The pfhrp2 gene was deleted in 10/300 (3.3%, 95% CI 1.6–6.0%) isolates, pfhrp3 in 9/300 (3.0%, 95% CI 1.4–5.6%) while both pfhrp2 and pfhrp3 were deleted in 10/300 (3.3%, 95% CI 1.6–6.0%) parasite isolates. Proportion of pfhrp2/3 deletions was higher in the eastern 14.7% (95% CI 9.7–20.0%) compared to the western region 3.1% (95% CI 0.8–7.7%), p = 0.001. Geographical location was associated with gene deletions aOR 6.25 (2.02–23.55), p = 0.003. Conclusions: This is the first large-scale survey reporting the presence of pfhrp2/3 gene deletions in P. falciparum isolates in Uganda. Roll out of RDTs for malaria diagnosis should take into consideration the existence of pfhrp2/3 gene deletions particularly in areas where they were detected. Periodic pfhrp2/3 surveys are recommended to inform future decisions for deployment of alternative RDTs. Keywords: Malaria rapid diagnostic tests, Plasmodium falciparum, Histidine rich protein 2, Histidine rich protein 3, Gene deletion, Deoxyribonucleic acid, Microscopy
*Correspondence: [email protected] 1 College of Health Sciences, Makerere University, Kampala, Uganda Full list of author information is available at the end of the article
Background In 2018, the World Health Organization (WHO) estimated there were 228 million cases and 405,000 deaths globally due to malaria. The WHO African Region
© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 Inte
Data Loading...
