TY - JOUR AU - Prosser, Christiane AU - Gresty, Karryn AU - Ellis, John AU - Meyer, Wieland AU - Anderson, Karen AU - Lee, Rogan AU - Cheng, Qin T1 - Plasmodium falciparum Histidine-Rich Protein 2 and 3 Gene Deletions in Strains from Nigeria, Sudan, and South Sudan T2 - Emerging Infectious Disease journal PY - 2021 VL - 27 IS - 2 SP - 471 SN - 1080-6059 AB - Deletion of histidine-rich protein genes pfhrp2/3 in Plasmodium falciparum causes infections to go undetected by HRP2-based malaria rapid diagnostic tests. We analyzed P. falciparum malaria cases imported to Australia (n = 210, collected 2010–2018) for their pfhrp2/3 status. We detected gene deletions in patients from 12 of 25 countries. We found >10% pfhrp2-deletion levels in those from Nigeria (13.3%, n = 30), Sudan (11.2%, n = 39), and South Sudan (17.7%, n = 17) and low levels of pfhrp3 deletion from Sudan (3.6%) and South Sudan (5.9%). No parasites with pfhrp2/3 double deletions were detected. Microsatellite typing of parasites from Nigeria, Sudan, and South Sudan revealed low relatedness among gene-deleted parasites, indicating independent emergences. The gene deletion proportions signify a risk of false-negative HRP2-RDT results. This study’s findings warrant surveillance to determine whether the prevalence of gene-deleted parasites justifies switching malaria rapid diagnostic tests in Nigeria, Sudan, and South Sudan. KW - Plasmodium falciparum KW - imported malaria KW - pfhrp2 KW - pfhrp3 KW - rapid diagnostic tests KW - travelers’ health KW - molecular surveillance KW - parasites KW - Nigeria KW - Sudan KW - South Sudan DO - 10.3201/eid2702.191410 UR - https://wwwnc.cdc.gov/eid/article/27/2/19-1410_article ER - End of Reference