Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting
Abstract Background Rapid diagnostic tests (RDTs) detecting the histidine-rich protein 2 (PfHRP2) have a central position for the management of Plasmodium falciparum infections. Yet, variable detection of certain targeted motifs, low parasitaemia, but also deletion of pfhrp2 gene or its homologue pf...
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ftdoajarticles:oai:doaj.org/article:1bcb3250665541c5bd13eb3177bdf98e 2023-05-15T15:17:49+02:00 Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting Grégoire Pasquier Vincent Azoury Milène Sasso Laëtitia Laroche Emmanuelle Varlet-Marie Sandrine Houzé Laurence Lachaud Patrick Bastien Yvon Sterkers Maude F. Leveque 2020-05-01T00:00:00Z https://doi.org/10.1186/s12936-020-03251-3 https://doaj.org/article/1bcb3250665541c5bd13eb3177bdf98e EN eng BMC http://link.springer.com/article/10.1186/s12936-020-03251-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-03251-3 1475-2875 https://doaj.org/article/1bcb3250665541c5bd13eb3177bdf98e Malaria Journal, Vol 19, Iss 1, Pp 1-9 (2020) False-negative RDTs Imported malaria Gene deletion Genetic diversity LAMP Screening Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2020 ftdoajarticles https://doi.org/10.1186/s12936-020-03251-3 2022-12-31T04:51:51Z Abstract Background Rapid diagnostic tests (RDTs) detecting the histidine-rich protein 2 (PfHRP2) have a central position for the management of Plasmodium falciparum infections. Yet, variable detection of certain targeted motifs, low parasitaemia, but also deletion of pfhrp2 gene or its homologue pfhrp3, may result in false-negative RDT leading to misdiagnosis and delayed treatment. This study aimed at investigating the prevalence, and understanding the possible causes, of P. falciparum RDT-negative infections at Montpellier Academic Hospital, France. Methods The prevalence of falsely-negative RDT results reported before and after the introduction of a loop-mediated isothermal amplification (LAMP) assay, as part as the malaria screening strategy in January 2017, was analysed. Negative P. falciparum RDT infections were screened for pfhrp2 or pfhrp3 deletion; and exons 2 were sequenced to show a putative genetic diversity impairing PfHRP2 detection. Results The overall prevalence of P. falciparum negative RDTs from January 2006 to December 2018 was low (3/446). Whereas no cases were reported from 2006 to 2016 (0/373), period during which the malaria diagnostic screen was based on microscopy and RDT, prevalence increased up to 4.1% (3/73) between 2017 and 2018, when molecular detection was implemented for primary screening. Neither pfhrp2/3 deletion nor major variation in the frequency of repetitive epitopes could explain these false-negative RDT results. Conclusion This paper demonstrates the presence of pfhrp2 and pfhrp3 genes in three P. falciparum RDT-negative infections and reviews the possible reasons for non-detection of HRP2/3 antigens in a non-endemic setting. It highlights the emergence of falsely negative rapid diagnostic tests in a non-endemic setting and draws attention on the risk of missing malaria cases with low parasitaemia infections using the RDT plus microscopy-based strategy currently recommended by French authorities. The relevance of a novel diagnostic scheme based upon a LAMP assay is ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 19 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
False-negative RDTs Imported malaria Gene deletion Genetic diversity LAMP Screening Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
False-negative RDTs Imported malaria Gene deletion Genetic diversity LAMP Screening Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Grégoire Pasquier Vincent Azoury Milène Sasso Laëtitia Laroche Emmanuelle Varlet-Marie Sandrine Houzé Laurence Lachaud Patrick Bastien Yvon Sterkers Maude F. Leveque Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting |
topic_facet |
False-negative RDTs Imported malaria Gene deletion Genetic diversity LAMP Screening Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Rapid diagnostic tests (RDTs) detecting the histidine-rich protein 2 (PfHRP2) have a central position for the management of Plasmodium falciparum infections. Yet, variable detection of certain targeted motifs, low parasitaemia, but also deletion of pfhrp2 gene or its homologue pfhrp3, may result in false-negative RDT leading to misdiagnosis and delayed treatment. This study aimed at investigating the prevalence, and understanding the possible causes, of P. falciparum RDT-negative infections at Montpellier Academic Hospital, France. Methods The prevalence of falsely-negative RDT results reported before and after the introduction of a loop-mediated isothermal amplification (LAMP) assay, as part as the malaria screening strategy in January 2017, was analysed. Negative P. falciparum RDT infections were screened for pfhrp2 or pfhrp3 deletion; and exons 2 were sequenced to show a putative genetic diversity impairing PfHRP2 detection. Results The overall prevalence of P. falciparum negative RDTs from January 2006 to December 2018 was low (3/446). Whereas no cases were reported from 2006 to 2016 (0/373), period during which the malaria diagnostic screen was based on microscopy and RDT, prevalence increased up to 4.1% (3/73) between 2017 and 2018, when molecular detection was implemented for primary screening. Neither pfhrp2/3 deletion nor major variation in the frequency of repetitive epitopes could explain these false-negative RDT results. Conclusion This paper demonstrates the presence of pfhrp2 and pfhrp3 genes in three P. falciparum RDT-negative infections and reviews the possible reasons for non-detection of HRP2/3 antigens in a non-endemic setting. It highlights the emergence of falsely negative rapid diagnostic tests in a non-endemic setting and draws attention on the risk of missing malaria cases with low parasitaemia infections using the RDT plus microscopy-based strategy currently recommended by French authorities. The relevance of a novel diagnostic scheme based upon a LAMP assay is ... |
format |
Article in Journal/Newspaper |
author |
Grégoire Pasquier Vincent Azoury Milène Sasso Laëtitia Laroche Emmanuelle Varlet-Marie Sandrine Houzé Laurence Lachaud Patrick Bastien Yvon Sterkers Maude F. Leveque |
author_facet |
Grégoire Pasquier Vincent Azoury Milène Sasso Laëtitia Laroche Emmanuelle Varlet-Marie Sandrine Houzé Laurence Lachaud Patrick Bastien Yvon Sterkers Maude F. Leveque |
author_sort |
Grégoire Pasquier |
title |
Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting |
title_short |
Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting |
title_full |
Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting |
title_fullStr |
Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting |
title_full_unstemmed |
Rapid diagnostic tests failing to detect infections by Plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting |
title_sort |
rapid diagnostic tests failing to detect infections by plasmodium falciparum encoding pfhrp2 and pfhrp3 genes in a non-endemic setting |
publisher |
BMC |
publishDate |
2020 |
url |
https://doi.org/10.1186/s12936-020-03251-3 https://doaj.org/article/1bcb3250665541c5bd13eb3177bdf98e |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 19, Iss 1, Pp 1-9 (2020) |
op_relation |
http://link.springer.com/article/10.1186/s12936-020-03251-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-03251-3 1475-2875 https://doaj.org/article/1bcb3250665541c5bd13eb3177bdf98e |
op_doi |
https://doi.org/10.1186/s12936-020-03251-3 |
container_title |
Malaria Journal |
container_volume |
19 |
container_issue |
1 |
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1766348061410328576 |