Abstract
BackgroundThe genetic variation in the Plasmodium falciparum histidine-rich protein 2 (pfhrp2) gene that may compromise the use of pfhrp2-based rapid diagnostic tests (RDTs) for the diagnosis of malaria was assessed in P. falciparum isolates from Yemen.MethodsThis study was conducted in Hodeidah and Al-Mahwit governorates, Yemen. A total of 622 individuals with fever were examined for malaria by CareStart™ malaria HRP2-RDT and Giemsa-stained thin and thick blood films. The Pfhrp2 gene was amplified and sequenced from 180 isolates, and subjected to amino acid repeat types analysis.ResultsA total of 188 (30.2 %) participants were found positive for P. falciparum by the RDT. Overall, 12 different amino acid repeat types were identified in Yemeni isolates. Six repeat types were detected in all the isolates (100 %) namely types 1, 2, 6, 7, 10 and 12 while types 9 and 11 were not detected in any of the isolates. Moreover, the sensitivity and specificity of the used PfHRP2-based RDTs were high (90.5 % and 96.1 %, respectively).ConclusionThe present study provides data on the genetic variation within the pfhrp2 gene, and its potential impact on the PfHRP2-based RDTs commonly used in Yemen. CareStart™ Malaria HRP2-based RDT showed high sensitivity and specificity in endemic areas of Yemen.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-015-1008-x) contains supplementary material, which is available to authorized users.
Highlights
The genetic variation in the Plasmodium falciparum histidine-rich protein 2 gene that may compromise the use of pfhrp2-based rapid diagnostic tests (RDTs) for the diagnosis of malaria was assessed in P. falciparum isolates from Yemen
Plasmodium falciparum is the predominant species and was responsible for almost 99 % of malaria cases in Yemen during 2012, a large number of which consisted of drug-resistant P. falciparum parasites [2, 3]
The present study investigated the genetic variation of PfHRP2 among isolates from Yemen, with a possible predicting effect on the performance of the PfHRP2based RDTs (CareStart® one-step HRP2 RDT; Access Bio Inc., New Jersey, USA) that are used solely for active case detection (ACD) by the national malaria control programme in Yemen (NMCP)
Summary
The genetic variation in the Plasmodium falciparum histidine-rich protein 2 (pfhrp2) gene that may compromise the use of pfhrp2-based rapid diagnostic tests (RDTs) for the diagnosis of malaria was assessed in P. falciparum isolates from Yemen. Plasmodium falciparum is the predominant species and was responsible for almost 99 % of malaria cases in Yemen during 2012, a large number of which consisted of drug-resistant P. falciparum parasites [2, 3]. Yemen is still classified among areas of high malaria transmission, making it the only country in the Arabian Peninsula and greater Middle Eastern region that is still plagued with malaria to the extent that residents still suffer from considerably high mortality and morbidity rates [2]. 2788 malaria cases were diagnosed in southern Saudi Arabia between 2011 and 2012, with about 97 % of the cases having been identified as originating outside the country, from the Tehama region, a Yemen bordered area [5]
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