Malaria diagnosis challenges and pfhrp2 and pfhrp3 gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso.

IF 4.9 4区 医学 Q1 PARASITOLOGY
Pathogens and Global Health Pub Date : 2024-09-01 Epub Date: 2024-08-14 DOI:10.1080/20477724.2024.2388489
Irene Molina-de la Fuente, Marc Christian Tahita, Kabore Bérenger, Thuy Huong Ta Tang, Luz García, Vicenta González, Agustín Benito, Judith M Hübschen, Halidou Tinto, Pedro Berzosa
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引用次数: 0

Abstract

Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and pfhrp2/3 deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe pfhrp2/3 deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. Pfhrp2 and pfhrp3 deletions were characterized for patients with confirmed P. falciparum infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, pfhrp2 deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher pfhrp2 deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso.

以布基纳法索纳诺罗地区的孕妇为哨点人群进行疟疾诊断的挑战与 pfhrp2 和 pfhrp3 基因缺失。
妊娠期疟疾会造成不良后果,及时准确的诊断对病例管理至关重要。在疟疾流行的国家,诊断主要基于快速诊断检测(RDT)和显微镜检查。然而,越来越多关于低寄生虫血症和 pfhrp2/3 基因缺失导致假阴性的报道引起了人们对基于 HRP2 的 RDT 是否有用的担忧。这项研究旨在评估 RDT 和显微镜检查的性能,并描述布基纳法索 418 名孕妇队列中 pfhrp2/3 基因缺失的情况。疟疾诊断采用 RDT 和显微镜检查,血样在产前检查时采集。诊断结果与作为金标准的 PCR 进行了比较。对确诊感染恶性疟原虫的患者进行了 Pfhrp2 和 pfhrp3 基因缺失鉴定。与显微镜检查(灵敏度 = 57%;特异性 = 98%)相比,RDT 的灵敏度更高(76%),但特异性更低(83%)。寄生虫血症(pfhrp2 基因缺失)较低,RDT 的假阴性率为 21.43%。在所有样本中都发现了较高的缺失频率,这与 RDT 结果无关,例如约 2% 的样本有双重缺失,这意味着大多数缺失对 RDT 检测没有影响。最后,在怀孕头三个月子宫高度较低的妇女中,pfhrp2 基因缺失率较高。建议在布基纳法索对孕妇进行更广泛的缺失监测研究。
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来源期刊
Pathogens and Global Health
Pathogens and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-PARASITOLOGY
CiteScore
6.00
自引率
0.00%
发文量
60
审稿时长
6-12 weeks
期刊介绍: Pathogens and Global Health is a journal of infectious disease and public health that focuses on the translation of molecular, immunological, genomics and epidemiological knowledge into control measures for global health threat. The journal publishes original innovative research papers, reviews articles and interviews policy makers and opinion leaders on health subjects of international relevance. It provides a forum for scientific, ethical and political discussion of new innovative solutions for controlling and eradicating infectious diseases, with particular emphasis on those diseases affecting the poorest regions of the world.
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