Assessment of Plasmodium falciparum histidine rich protein 2 and /3 (pfhrp 2 & amp;/ pfhrp 3) gene deletion or mutation in Plasmodium falciparum positive blood samples in a tertiary care centre in South India

This study was conducted for a period of 2  years in a tertiary care centre in South India. Blood samples that are microscopically confirmed asP. falciparum but negative by RDT were assessed for the presence ofpfhrp2,pfhrp3, and their flanking genes using conventional PCR. Follow up of the clinical outcomes were also done for these patients. Of the 63 positive samples collected (50 /63) 79.4% wereP.vivax and (13/63) 20.6% wereP.falciparum by PCR. Among the 13P. falciparum positive samples, 4 samples (4/13), (95% CI -10.36% to 61.11%) were found to be RDT negative but microscopically positive.Pfhrp2,pfhrp3 and their flanking genes were amplified for these 4 samples. All 4 samples were found to be negative for bothpfhrp2-2& pfhrp2-3 exon regions and also varying patterns of flanking gene deletions were also noted.This study provides molecular evidence for the existence ofpfhrp2&pfhrp3 deletedP. falciparum parasites in a tertiary care centre in South India warranting periodic evaluation ofpfhrp2 based RDT use. Onlypfhrp2/3 RDT based decision on diagnosis ofP.falciparum malaria should always be reconsidered especially in remote areas.
Source: Journal of Parasitic Diseases - Category: Parasitology Source Type: research