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Gene deletion P.falciparum mutants pose challenge to widely used diagnostic tests and eradication efforts

December 6, 2016 - 21:36 -- David Tordrup

In a current paper in the Journal of Infectious Diseases, recently reviewed at Global Health Technology Review, Dr. Jonathan Parr (University of North Carolina) examines cases of RDT-negative P.falciparum cases as part of the Demographic Health Survey of Democratic Republic of the Congo. A non-trivial proportion of RDT-negative infections were PCR-positive, and were caused by parasites with a deletion in the PfHRP2 (histidine-rich protein 2) gene, which codes for the antigen recognised by the most widely used RDT's. The paper also demonstrated clustering of the PfHRP2 deletion mutants in Kinshasa and Kivu provinces, where RDT's were first introduced, suggesting an "escape mutant" scenario in which RDT detection and subsequent treatment of malaria exerts selective pressure on the parasite. Dr. Parr's paper is reviewed further and referenced at Global Health Technology Review