Performance of rapid diagnostic tests - Histidine Rich Protein 2 and deletions in the pfhrp2 gene in the rural commune of Nanoro, Burkina Faso
DOI:
https://doi.org/10.64707/revstss.v49i1.2023Keywords:
Malaria, Diagnosis, pfhrp2, Deletions, Burkina FasoAbstract
Introduction: Malaria diagnosis mainly relies on rapid diagnostic tests in peripheral health facilities. However, the emergence of Plasmodium falciparum strains with deletions in the pfhrp2 gene which is the main target of many RDTs, raises concerns about the reliability of these tools. This study aimed to assess the performance of RDTs and estimate the rate of pfhrp2 deletions in cases of discrepancies between RDT and microscopy results.
Methods: Between July and November 2020, children aged 6 to 59 months were included. A blood sample was collected from each participant for malaria diagnosis by both RDT and microscopy. Samples with discordant results were subjected to detection of pfhrp2 gene deletions by PCR.
Results: A total of 1,059 children were included. RDT sensitivity was 77.06% with a specificity of 84.01% compared to microscopy. There were 200 (49%) cases of discrepancy between RDT and microscopy results. Out of them, 2.58% had pfhrp2 deletions.
Conclusion: This study reports a relatively high discrepancy rate between RDT and microscopy, with some cases exhibiting deletions in the pfhrp2 gene. Although the prevalence remains below the 5% threshold set by the WHO for recommending a change in RDT, continuous large-scale monitoring is necessary to track the evolution of these strains in Burkina Faso.
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