Rapid diagnostic tests for malaria diagnosis in the Peruvian Amazon: impact of pfhrp2 gene deletions and cross-reactions.

摘要: Background: In the Peruvian Amazon, Plasmodium falciparum and vivax malaria are endemic in rural areas, where microscopy is not available. Malaria rapid diagnostic tests (RDTs) provide quick accurate diagnosis. However, pfhrp2 gene deletions may limit use of histidine-rich protein-2 (PfHRP2) detecting RDTs. Further, cross-reactions P. with vivax-specific test lines vice versa impair specificity. Methods: Thirteen RDT products were evaluated on 179 prospectively collected positive samples. Species diagnosis was performed by confirmed PCR. Pfhrp2 assessed Results: Sensitivity for lower PfHRP2 compared to falciparum-specific lactate dehydrogenase (Pf-pLDH)- RDTs (71.6% vs. 98.7%, p,0.001). Most (19/21) false negative results associated (25.7% 74 samples). Diagnostic sensitivity (101 samples) excellent, except two products. 10/12 vivax-detecting products, or PfpLDH line occurred at a median frequency 2.5% (range 0%–10.9%) samples assessed. one respectively cross-reacted Pv-pLDH line. Two Pf-pLDH/pan-pLDH-detecting showed excellent few (1.0%) but faint Pf-pLDH 24.7% 38.9% Conclusion: PfHRP2-detecting suitable Amazon due deletions. Pf-pLDHdetecting excellently promising this region although concern.