Genetic diversity of Plasmodium falciparum histidine-rich protein 2 (PfHRP2) and its effect on the performance of PfHRP2-based rapid diagnostic tests

Baker, Joanne, McCarthy, James, Gatton, Michelle, Kyle, Dennis E., Belizario, Vicente, Luchavez, Jennifer, Bell, David and Cheng, Qin (2005) Genetic diversity of Plasmodium falciparum histidine-rich protein 2 (PfHRP2) and its effect on the performance of PfHRP2-based rapid diagnostic tests. Journal of Infectious Diseases, 192 5: 870-877. doi:10.1086/432010


Author Baker, Joanne
McCarthy, James
Gatton, Michelle
Kyle, Dennis E.
Belizario, Vicente
Luchavez, Jennifer
Bell, David
Cheng, Qin
Title Genetic diversity of Plasmodium falciparum histidine-rich protein 2 (PfHRP2) and its effect on the performance of PfHRP2-based rapid diagnostic tests
Journal name Journal of Infectious Diseases   Check publisher's open access policy
ISSN 0022-1899
Publication date 2005
Sub-type Article (original research)
DOI 10.1086/432010
Volume 192
Issue 5
Start page 870
End page 877
Total pages 8
Editor M. S. Hirsch
Place of publication Chicago, U.S.A.
Publisher University of Chicago Press
Collection year 2005
Language eng
Subject 321299 Public Health and Health Services not elsewhere classified
730299 Public health not elsewhere classified
Abstract Rising costs of antimalarial agents are increasing the demand for accurate diagnosis of malaria. Rapid diagnostic tests (RDTs) offer great potential to improve the diagnosis of malaria, particularly in remote areas. Many RDTs are based on the detection of Plasmodium falciparum histidine-rich protein (PfHRP) 2, but reports from field tests have questioned their sensitivity and reliability. We hypothesize that the variability in the results of PfHRP2-based RDTs is related to the variability in the target antigen. We tested this hypothesis by examining the genetic diversity of PfHRP2, which includes numerous amino acid repeats, in 75 P. falciparum lines and isolates originating from 19 countries and testing a subset of parasites by use of 2 PfHRP2-based RDTs. We observed extensive diversity in PfHRP2 sequences, both within and between countries. Logistic regression analysis indicated that 2 types of repeats were predictive of RDT detection sensitivity (87.5% accuracy), with predictions suggesting that only 84% of P. falciparum parasites in the Asia-Pacific region are likely to be detected at densities <= 250 parasites/mu L. Our data also indicated that PfHRP3 may play a role in the performance of PfHRP2-based RDTs. These findings provide an alternative explanation for the variable sensitivity in field tests of malaria RDTs that is not due to the quality of the RDTs.
Keyword Infectious Diseases
Plasmodium-falciparum Malaria
Histidine-rich Protein-2
Expert Microscopy
Immunochromatographic Test
Field
Antigen
Parasites
Assays
Travelers
Accuracy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
 
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