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Rapid Diagnostic Tests for Malaria Diagnosis in the Peruvian Amazon: Impact of pfhrp2 Gene Deletions and Cross-Reactions

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dc.contributor.author Maltha, J.
dc.contributor.author Gamboa Vilela, Dionicia Baziliza
dc.contributor.author Bendezu, J.
dc.contributor.author Sanchez, L.
dc.contributor.author Cnops, L.
dc.contributor.author Gillet, P.
dc.contributor.author Jacobs, J.
dc.date.accessioned 2022-01-18T19:34:39Z
dc.date.available 2022-01-18T19:34:39Z
dc.date.issued 2012
dc.identifier.uri https://hdl.handle.net/20.500.12866/11102
dc.description.abstract Background: In the Peruvian Amazon, Plasmodium falciparum and Plasmodium vivax malaria are endemic in rural areas, where microscopy is not available. Malaria rapid diagnostic tests (RDTs) provide quick and accurate diagnosis. However, pfhrp2 gene deletions may limit the use of histidine-rich protein-2 (PfHRP2) detecting RDTs. Further, cross-reactions of P. falciparum with P. vivax-specific test lines and vice versa may impair diagnostic specificity. Methods: Thirteen RDT products were evaluated on 179 prospectively collected malaria positive samples. Species diagnosis was performed by microscopy and confirmed by PCR. Pfhrp2 gene deletions were assessed by PCR. Results: Sensitivity for P. falciparum diagnosis was lower for PfHRP2 compared to P. falciparum-specific Plasmodium lactate dehydrogenase (Pf-pLDH)- detecting RDTs (71.6% vs. 98.7%, p<0.001). Most (19/21) false negative PfHRP2 results were associated with pfhrp2 gene deletions (25.7% of 74 P. falciparum samples). Diagnostic sensitivity for P. vivax (101 samples) was excellent, except for two products. In 10/12 P. vivax-detecting RDT products, cross-reactions with the PfHRP2 or Pf-pLDH line occurred at a median frequency of 2.5% (range 0%-10.9%) of P. vivax samples assessed. In two RDT products, two and one P. falciparum samples respectively cross-reacted with the Pv-pLDH line. Two Pf-pLDH/pan-pLDH-detecting RDTs showed excellent sensitivity with few (1.0%) cross-reactions but showed faint Pf-pLDH lines in 24.7% and 38.9% of P. falciparum samples. Conclusion: PfHRP2-detecting RDTs are not suitable in the Peruvian Amazon due to pfhrp2 gene deletions. Two Pf-pLDH-detecting RDTs performed excellently and are promising RDTs for this region although faint test lines are of concern. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Peru en_US
dc.subject major clinical study en_US
dc.subject diagnostic test en_US
dc.subject gene deletion en_US
dc.subject Malaria en_US
dc.subject Plasmodium vivax en_US
dc.subject Plasmodium falciparum en_US
dc.subject rapid diagnostic test en_US
dc.subject Polymerase Chain Reaction en_US
dc.subject gene en_US
dc.subject Geography en_US
dc.subject Models, Genetic en_US
dc.subject Microscopy en_US
dc.subject real time polymerase chain reaction en_US
dc.subject Prospective Studies en_US
dc.subject malaria falciparum en_US
dc.subject Plasmodium vivax malaria en_US
dc.subject Protozoan Proteins en_US
dc.subject mixed infection en_US
dc.subject enzyme linked immunosorbent assay en_US
dc.subject DNA extraction en_US
dc.subject diagnostic accuracy en_US
dc.subject diagnostic procedure en_US
dc.subject microscopy en_US
dc.subject Antigens, Protozoan en_US
dc.subject sensitivity analysis en_US
dc.subject cross reaction en_US
dc.subject lactate dehydrogenase en_US
dc.subject Gene Deletion en_US
dc.subject histidine rich protein 2 gene en_US
dc.subject histidine rich protein 3 gene en_US
dc.title Rapid Diagnostic Tests for Malaria Diagnosis in the Peruvian Amazon: Impact of pfhrp2 Gene Deletions and Cross-Reactions en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0043094
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.00
dc.relation.issn 1932-6203


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