Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Tropical Diseases Research Centre, Ndola, Zambia.
Am J Trop Med Hyg. 2019 Apr;100(4):842-845. doi: 10.4269/ajtmh.18-0859.
We attempted to identify histidine-rich protein 2/3 () deletions among rapid diagnostic test (RDT)-negative but PCR- or microscopy-positive -infected individuals in areas of low transmission (Choma District, 2009-2011) and high transmission (Nchelenge District, 2015-2017) in Zambia. Through community-based surveys, 5,167 participants were screened at 1,147 households by histidine-rich protein 2 (PfHRP2)-based RDTs. Slides were made and dried blood spots were obtained for molecular analysis. Of 28 samples with detectable DNA, none from Nchelenge District were negative. All eight samples from Choma District had detectable genes, but was undetectable in three. DNA concentrations of -negative samples were low (< 0.001 ng/μL). These findings suggest that PfHRP2-based RDTs remain effective tools for malaria diagnosis in Nchelenge District, but further study is warranted to understand the potential for deletions in southern Zambia where malaria transmission declined over the past decade.
我们试图在低传播地区（2009-2011 年的乔马区）和高传播地区（2015-2017 年的恩切伦格区）的快速诊断检测（RDT）阴性但 PCR 或显微镜阳性感染个体中鉴定富含组氨酸蛋白 2/3（）缺失。通过基于社区的调查，在 1147 户家庭中，5167 名参与者接受了基于富含组氨酸蛋白 2（PfHRP2）的 RDT 筛查。制作了载玻片并采集了干血斑进行分子分析。在可检测到 DNA 的 28 个样本中，来自恩切伦格区的没有一个是阴性的。来自乔马区的所有 8 个样本都检测到了 基因，但在 3 个样本中无法检测到。-阴性样本的 DNA 浓度较低（<0.001 ng/μL）。这些发现表明，基于 PfHRP2 的 RDT 仍然是恩切伦格区疟疾诊断的有效工具，但需要进一步研究以了解过去十年疟疾传播下降的赞比亚南部地区缺失的可能性。
