Prevalence of Plasmodium falciparum isolates lacking the histidine rich protein 2 gene among symptomatic malaria patients in Kwilu Province of the Democratic Republic of Congo.
Prevalence of Plasmodium falciparum isolates lacking the histidine rich protein 2 gene among symptomatic malaria patients in Kwilu Province of the Democratic Republic of Congo.
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DOI：
10.1186/s40249-021-00860-1
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发表时间：
2021-05-25
影响因子：
8.1
通讯作者：
Culleton R
中科院分区：
文献类型：
--
作者：
Munyeku YB;Musaka AA;Ernest M;Smith C;Mansiangi PM;Culleton R
疟疾快速诊断检测已成为疟疾流行国家疟疾诊断的主要和关键工具，这些国家广泛使用基于恶性疟原虫富含组氨酸蛋白2的快速诊断检测（基于PfHRP2的RDT）。然而，在过去的十年中，基于 PfHRP2 的 RDT 的准确性受到了恶性疟原虫菌株的出现的挑战，该菌株含有恶性疟原虫富含组氨酸的蛋白 2 (pfhrp2) 基因的缺失，导致假阴性结果。在刚果民主共和国 (D.R. Congo)，人们对感染有症状患者的恶性疟原虫分离株中 pfhrp2 基因缺失的流行情况知之甚少，特别是在假定 pfhrp2 缺失寄生虫出现和传播的低至中度传播地区。在这里，我们确定了刚果民主共和国奎卢省有症状的疟疾患者的当地患病率和与 pfhrp2 基因缺失相关的因素。刚果。我们使用了 2018 年进行的一项基于前瞻性医疗机构的横断面研究的二手数据。收集血液进行显微镜检查、PfHRP2-RDT，并点样到 Whatman 滤纸上进行下游遗传分析。提取基因组 DNA 并用于进行 PCR 测定，以检测和确认 pfhrp2 基因缺失。 Fischer 精确检验和 Kruskal-Wallis 检验用于寻找潜在解释变量与 pfhrp2 基因缺失之间的关联，统计显着性水平设定为 P<0.05。在 684 名有症状患者中，391 名（57.7%）为女性。大多数人（87.7%）报告说家中存在蚊子孳生地，发烧是报告最多的症状（81.6%）。 pfhrp2 基因缺失的总体患病率为 9.2%（95% CI：6.7%–12.1%）。 pfhrp2基因的缺失与健康来源地区（P = 0.012）和年龄（P = 0.019）相关。在 PfHRP2-RDT 假阴性结果中，只有 9.9% 是由于 pfhrp2 基因缺失造成的。具有 pfhrp2 基因缺失的恶性疟原虫分离株在奎卢省有症状的患者中相对常见。需要进一步调查，为政策改变提供足够的证据。同时，使用针对 PfHRP2 和寄生虫乳酸脱氢酶 (pLDH) 抗原的 RDT 可以限制缺失菌株的传播。
Malaria rapid diagnostic tests have become a primary and critical tool for malaria diagnosis in malaria-endemic countries where Plasmodium falciparum Histidine Rich Protein 2-based rapid diagnostic tests (PfHRP2-based RDTs) are widely used. However, in the last decade, the accuracy of PfHRP2-based RDTs has been challenged by the emergence of P. falciparum strains harbouring deletions of the P. falciparum histidine rich protein 2 (pfhrp2) gene, resulting in false-negative results. In the Democratic Republic of Congo (D.R. Congo), little is known about the prevalence of the pfhrp2 gene deletion among P. falciparum isolates infecting symptomatic patients, especially in low to moderate transmission areas where pfhrp2 deletion parasites are assumed to emerge and spread. Here we determine the local prevalence and factors associated with pfhrp2 gene deletions among symptomatic malaria patients in the Kwilu Province of the D.R. Congo. We used secondary data from a prospective health facility-based cross-sectional study conducted in 2018. Blood was collected for microscopy, PfHRP2-RDT, and spotted onto Whatman filter paper for downstream genetic analysis. Genomic DNA was extracted and used to perform PCR assays for the detection and confirmation of pfhrp2 gene deletions. Fischer’s exact and the Kruskal–Wallis tests were applied to look for associations between potential explanatory variables and the pfhrp2 gene deletion with a level of statistical significance set at P < 0.05. Of the 684 enrolled symptomatic patients, 391 (57.7%) were female. The majority (87.7%) reported the presence of mosquito breeding sites within the household’s compound, and fever was the most reported symptom (81.6%). The overall prevalence of the pfhrp2 gene deletion was 9.2% (95% CI: 6.7%–12.1%). The deletion of the pfhrp2 gene was associated with health zone of origin (P = 0.012) and age (P = 0.019). Among false-negative PfHRP2-RDT results, only 9.9% were due to pfhrp2 gene deletion. P. falciparum isolates with pfhrp2 gene deletions are relatively common among symptomatic patients in Kwilu province. Further investigations are needed to provide enough evidence for policy change. Meanwhile, the use of RDTs targeting PfHRP2 and parasite lactate dehydrogenase (pLDH) antigens could limit the spread of deleted isolates.
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影响因子：
3
作者：
Cnops L;Boderie M;Gillet P;Van Esbroeck M;Jacobs J
通讯作者：
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影响因子：
3.7
作者：
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缺乏富含组氨酸的蛋白 2 和 3 的恶性疟原虫寄生虫：准确报告的回顾和建议。
影响因子：
3
作者：
Cheng Q;Gatton ML;Barnwell J;Chiodini P;McCarthy J;Bell D;Cunningham J
通讯作者：
Cunningham J