London, England.
Division of Infectious Diseases, University of North Carolina, Chapel Hill, United States of America.
Bull World Health Organ. 2020 Aug 1;98(8):558-568F. doi: 10.2471/BLT.20.250621. Epub 2020 Jun 19.
To calculate prevalence estimates and evaluate the quality of studies reporting lacking histidine-rich proteins 2 and 3, to inform an international response plan.
We searched five online databases, without language restriction, for articles reporting original data on -infected patients with deletions of the and/or genes (). We calculated prevalence estimates of deletions and mapped the data by country. The denominator was all -positive samples testing positive by microscopy and confirmed positive by species-specific polymerase chain reaction testing (PCR). If microscopy was not performed, we used the number of samples based on a different diagnostic method or PCR alone. We scored studies for risk of bias and the quality of laboratory methods using a standardized scoring system.
A total of 38 articles reporting 55 studies from 32 countries and one territory worldwide were included in the review. We found considerable heterogeneity in the populations studied, methods used and estimated prevalence of parasites with deletions. The derived prevalence of deletions ranged from 0% to 100%, including focal areas in South America and Africa. Only three studies (5%) fulfilled all seven criteria for study quality.
The lack of representative surveys or consistency in study design impairs evaluations of the risk of false-negative results in malaria diagnosis due to deletions. Accurate mapping and strengthened monitoring of the prevalence of deletions is needed, along with harmonized methods that facilitate comparisons across studies.
计算缺乏富含组氨酸蛋白 2 和 3 的流行率估计值并评估报告这些研究的质量，以为国际应对计划提供信息。
我们在五个在线数据库中进行了无语言限制的检索，以获取报告缺失 和/或 基因（）的 - 感染患者的原始数据的文章。我们计算了 缺失的流行率估计值，并按国家/地区绘制了数据图。分母是所有通过显微镜检查呈阳性且经种特异性聚合酶链反应（PCR）检测确认阳性的 - 阳性样本。如果未进行显微镜检查，则使用基于不同诊断方法或仅使用 PCR 的样本数量。我们使用标准化评分系统对研究的偏倚风险和实验室方法的质量进行评分。
共有 38 篇文章报道了来自全球 32 个国家和一个地区的 55 项研究，包括在全球范围内进行的研究。我们发现，所研究的人群、使用的方法和估计的 寄生虫缺失的流行率存在很大差异。 缺失的推导流行率从 0%到 100%不等，包括南美洲和非洲的局部地区。只有三项研究（5%）满足研究质量的所有七个标准。
由于缺乏代表性的调查或研究设计的一致性，因此评估由于 缺失导致的疟疾诊断假阴性结果的风险受到了损害。需要对 缺失的流行率进行准确的绘图和加强监测，并采用有助于比较研究的协调方法。
