Prevalence of Plasmodium falciparum histidine-rich protein 2/3 gene deletions in isolates collected from patients in Mossendjo health centres, the Republic of the Congo

Résumé

Abstract Rapid diagnostic tests (RDTs) based on histidine-rich protein (HRP) are widely used for malaria diagnosis. However, false-negative results from these RDTs, due to deletions in the Plasmodium falciparum ( P. falciparum ) Pfhrp2/3 genes, are an obstacle to malaria control. The current study aimed to determine the prevalence of deletions in the Pfhrp2/3 genes in P. falciparum isolates from Mossendjo. Blood samples were collected from patients with signs of uncomplicated malaria at the Integrated Health Center and the Base Hospital in Mossendjo, from January to December 2022. P. falciparum positive samples were selected based on msp1 / 2 genotyping. These positive samples were used for the screening of Pfhrp2/3 deletions by nested PCR, and negative samples were subsequently run by real-time PCR to confirm deletions in the Pfhrp2 /3 genes. Of the 660 P. falciparum positive samples, 600 (90.9%) were positive for Pfhrp2 and Pfhrp3 genes, and 60 (9.1%) remained negative by nested PCR. Following real-time PCR, deletions in the Pfhrp3 gene were confirmed in 12 negative samples. No deletions were observed in the Pfhrp2 gene. Among the 12 Pfhrp3 deleted samples, 83.3% came from adults and 16.7% from children, and 66.7% from women compared to 33.3% from men. This study revealed a low prevalence of deletions in the Pfhrp3 gene and no deletions in the Pfhrp2 gene. Thus, HRP2-based RDTs can still be used reliably in Mossendjo. However, evaluation of their performance and regular monitoring of these genes remain necessary, as recommended by the World Health Organization.

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