Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
School of Medicine Addis, Ababa University, Addis Ababa, Ethiopia.
Malar J. 2022 Jan 29;21(1):26. doi: 10.1186/s12936-022-04051-7.
The usefulness of histidine-rich protein-2/3 (HRP2/3)-based rapid diagnostic tests of malaria due to Plasmodium falciparum has been threatened by the appearance of mutant PfHRP2/3 genes. This study was undertaken to determine the global pooled estimates of PfHRP2/3gene deletions.
Relevant publications were identified from electronic databases such as; PubMed, EMBASE, and MEDLINE online. Besides, all the relevant literatures were retrieved through Google and Google Scholar. STATA software was used for data analysis. The pooled estimates were calculated using random effect model. The summary estimates were presented using forest plots and tables.
A total of 27 studies were included in the systematic review. However, only 24 and 17 studies were included for PfHRP2 and 3 gene deletion meta-analysis, respectively. The prevalence of PfHRP2 gene deletion across the individual studies ranged from the highest 100% to the lowest 0%. However, the meta-analysis result showed that the global pooled prevalence of PfHRP2 and PfHRP3 gene deletions were 21.30% and 34.50%, respectively. The pooled proportion of PfHRP2 gene deletion among false negative PfHRP2-based RDTs results was found to be 41.10%. The gene deletion status was higher in South America and followed by Africa. The pooled estimate of PfHRP2 gene deletion among studies, which did not follow the WHO PfHRP2/3 gene deletion analysis protocol was higher than their counter parts (21.3% vs 10.5%).
This review showed that there is a high pooled prevalence of PfHRP2/3 gene deletions in Plasmodium falciparum confirmed isolates and also a high proportion of their deletions among false-negative malaria cases using PfHRP2-based RDT results. Hence, malaria diagnosis based on PfHRP2-based rapid tests seems to be less sensitive and warrants further evaluation of PfHRP2/3 gene deletions.
由于恶性疟原虫 PfHRP2/3 基因突变，基于组氨酸丰富蛋白 2/3（HRP2/3）的快速诊断试验在疟疾检测中的有效性受到了威胁。本研究旨在确定全球 PfHRP2/3 基因缺失的汇总估计值。
从电子数据库（如 PubMed、EMBASE 和 MEDLINE 在线）中检索相关文献。此外，通过 Google 和 Google Scholar 检索所有相关文献。使用 STATA 软件进行数据分析。使用随机效应模型计算汇总估计值。使用森林图和表格呈现汇总估计值。
本系统评价共纳入 27 项研究。然而，只有 24 项和 17 项研究分别纳入 PfHRP2 和 3 基因缺失的荟萃分析。个体研究中 PfHRP2 基因缺失的流行率范围从最高的 100%到最低的 0%。然而，荟萃分析结果表明，全球 PfHRP2 和 PfHRP3 基因缺失的总体流行率分别为 21.30%和 34.50%。假阴性 PfHRP2 基 RDT 结果中 PfHRP2 基因缺失的合并比例为 41.10%。南美洲和非洲的基因缺失率较高。未遵循世卫组织 PfHRP2/3 基因缺失分析方案的研究中 PfHRP2 基因缺失的合并估计值高于其对照组（21.3%比 10.5%）。
本综述表明，在恶性疟原虫确认分离株中 PfHRP2/3 基因缺失的总体流行率较高，且 PfHRP2 基 RDT 结果中假阴性疟疾病例的基因缺失比例也较高。因此，基于 PfHRP2 的快速检测似乎不太敏感，需要进一步评估 PfHRP2/3 基因缺失。
