Prevalence of histidine-rich protein 2 deletion among the isolates from Kolkata.

CONTEXT

Histidine-rich protein 2 (HRP2) detecting rapid diagnostic tests (RDTs) have played an important role in enabling prompt malaria diagnosis in remote locations. HRP2 has advantages over other biomarkers because of its abundance in the bloodstream, repetitive binding epitopes, and falciparum-specificity. Most HRP2-based RDTs also exhibit some cross-reactivity to a closely related protein (HRP3) parasites lacking HRP2 () and 3 () genes escape detection by these RDTs.

OBJECTIVES

The objective of the study was to study the sensitivity and specificity of hrp2-based RDT for diagnosis of falciparum, to compare the RDT results with microscopy and polymerase chain reaction (PCR), and to determine the prevalence of HRP2 gene deletion among the RDT-negative, microscopy-positive falciparum strains.

MATERIALS AND METHODS

Blood samples were collected and diagnosis was done by microscopic examination, RDTs, and PCR.

RESULTS

Out of 1000 patients examined, 138 were positive for . Fever was the most common symptom followed by chills with rigor and headache were recorded among more than >95% of the study patients. Three microscopy-confirmed cases were negative by HRP2-based RDT and were found to have deletion of HRP2 and HRP3 exon 2.

CONCLUSIONS

Rapid and accurate diagnosis and prompt deployment of effective antimalarial medication are essential components of appropriate case management. strains that evade diagnosis by RDTs represent a major threat to malaria control and elimination efforts.