Emerg Infect Dis. 2021 Feb;27(2):471-479. doi: 10.3201/eid2702.191410.
Deletion of histidine-rich protein genes pfhrp2/3 in Plasmodium falciparum causes infections to go undetected by HRP2-based malaria rapid diagnostic tests. We analyzed P. falciparum malaria cases imported to Australia (n = 210, collected 2010-2018) for their pfhrp2/3 status. We detected gene deletions in patients from 12 of 25 countries. We found >10% pfhrp2-deletion levels in those from Nigeria (13.3%, n = 30), Sudan (11.2%, n = 39), and South Sudan (17.7%, n = 17) and low levels of pfhrp3 deletion from Sudan (3.6%) and South Sudan (5.9%). No parasites with pfhrp2/3 double deletions were detected. Microsatellite typing of parasites from Nigeria, Sudan, and South Sudan revealed low relatedness among gene-deleted parasites, indicating independent emergences. The gene deletion proportions signify a risk of false-negative HRP2-RDT results. This study's findings warrant surveillance to determine whether the prevalence of gene-deleted parasites justifies switching malaria rapid diagnostic tests in Nigeria, Sudan, and South Sudan.
富组氨酸蛋白 2/3 基因缺失可导致恶性疟原虫感染无法被基于 HRP2 的疟疾快速诊断检测试剂检出。我们对澳大利亚输入性疟疾病例(n=210,收集时间为 2010 年至 2018 年)进行 pfhrp2/3 状态分析。在来自 25 个国家的患者中检测到基因缺失。我们发现,来自尼日利亚(13.3%,n=30)、苏丹(11.2%,n=39)和南苏丹(17.7%,n=17)的患者中 pfhrp2 缺失水平超过 10%,而苏丹(3.6%)和南苏丹(5.9%)的患者中 pfhrp3 缺失水平较低。未检测到 pfhrp2/3 双缺失的寄生虫。来自尼日利亚、苏丹和南苏丹的寄生虫微卫星分型显示,基因缺失的寄生虫之间相关性较低,表明其独立出现。基因缺失比例表明 HRP2-RDT 结果可能出现假阴性。本研究结果需要进行监测,以确定尼日利亚、苏丹和南苏丹是否需要更换疟疾快速诊断检测试剂,因为基因缺失寄生虫的流行率可能会导致假阴性结果。