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Agaba BB, Yeka A, Nsobya S, Arinaitwe E, Nankabirwa J, Opigo J, Mbaka P, Lim CS, Kalyango JN, Karamagi C, Kamya MR. Systematic review of the status of pfhrp2 and pfhrp3 gene deletion, approaches and methods used for its estimation and reporting in Plasmodium falciparum populations in Africa: review of published studies 2010-2019. Malar J 2019; 18:355. [PMID: 31694718 PMCID: PMC6836395 DOI: 10.1186/s12936-019-2987-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/24/2019] [Indexed: 12/13/2022] Open
Abstract
Background Malaria rapid diagnostic tests based on histidine-rich protein-2 have played a vital role in improving malaria case management and surveillance particularly in Africa, where Plasmodium falciparum is predominant. However, their usefulness has been threatened by the emergence of gene deletion on P. falciparum histidine rich protein 2 (pfhrp2) and P. falciparum histidine rich protein 3 (pfhrp3). Use of standard and recommended methods is key for accurate investigation, confirmation and reporting of pfhrp2 and pfhrp3 gene deletion. Methods A systematic review was conducted to assess the status, methods and approaches that have been used for investigation, confirmation and reporting of pfhrp2 and pfhrp3 gene deletion in Africa. An online search was done using PubMed and MEDLINE Google Scholar for all articles published in English on pfhrp2/3 gene deletion in Africa. Relevant articles that met the inclusion criteria were summarized and assessed based on the protocol recommended by the World Health Organization for confirmation and reporting of pfhrp2/3 gene deletion. Results The search identified a total of 18 articles out of which 14 (77.7%) fulfilled the criteria for inclusion and were retained for review. The articles were distributed across 12 countries where the pfhrp2 and pfhrp3 gene deletion studies were conducted and reported. The level of pfhrp2/3 gene deletion across selected studies in Africa ranged from the highest 62% to the lowest 0.4%. There was wide variation in methods and approaches including study designs, size and sampling and whether both pfhrp2 and pfhrp3 double deletions or pfhrp2 single deletion were investigated, with a wide variation in laboratory methods. Conclusion Based on the review, there is evidence of the presence of pfhrp2/3 gene-deleted P. falciparum parasites in Africa. The approaches and methods used for investigation, confirmation and reporting of pfhrp2/3 deleted parasites have varied between studies and across countries. Countries that are considering plans to investigate, confirm and report pfhrp2/3 deletion should use recommended standard and harmonized methods to prevent unnecessary recommendations for costly switch of RDTs in Africa.
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Affiliation(s)
- Bosco B Agaba
- School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda. .,Clinical Epidemiology Unit, Makerere University Kampala, Kampala, Uganda. .,National Malaria Control Programme, Kampala, Uganda.
| | - Adoke Yeka
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sam Nsobya
- School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Joaniter Nankabirwa
- School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda.,Clinical Epidemiology Unit, Makerere University Kampala, Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Jimmy Opigo
- National Malaria Control Programme, Kampala, Uganda
| | - Paul Mbaka
- World Health Organization Country Office, Kampala, Uganda
| | - Chae Seung Lim
- Department of Laboratory Medicine, College of Health Sciences, Korea University, Seoul, South Korea
| | - Joan N Kalyango
- Clinical Epidemiology Unit, Makerere University Kampala, Kampala, Uganda
| | - Charles Karamagi
- Clinical Epidemiology Unit, Makerere University Kampala, Kampala, Uganda
| | - Moses R Kamya
- School of Medicine, College of Health Sciences Makerere University, Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
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