Evaluation of Histidine-Rich Proteins 2 and 3 Gene Deletions in Plasmodium falciparum in Endemic Areas of the Brazilian Amazon

Leandro Góes, Nathália Chamma-Siqueira, José Mário Peres, José Maria Nascimento, Suiane Valle, Ana Ruth Arcanjo, Marcus Lacerda, Liana Blume, Marinete Póvoa and Giselle Viana
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Leandro Góes: Graduate Program in Epidemiology and Health Surveillance (PPGEVS), Centre for Education and Graduate Programs (NEP), Evandro Chagas Institute (IEC/SVS/MS), 67.030-000 Ananindeua, Pará, Brazil
Nathália Chamma-Siqueira: Parasitology Section, Evandro Chagas Institute-IEC/SVS/MS, 67.030-000 Ananindeua, Pará, Brazil
José Mário Peres: Parasitology Section, Evandro Chagas Institute-IEC/SVS/MS, 67.030-000 Ananindeua, Pará, Brazil
José Maria Nascimento: Parasitology Section, Evandro Chagas Institute-IEC/SVS/MS, 67.030-000 Ananindeua, Pará, Brazil
Suiane Valle: Hemonúcleo Cruzeiro do Sul, State Health Department of Acre, 69.980-000 Cruzeiro do Sul, Acre, Brazil
Ana Ruth Arcanjo: Central Public Health Laboratory of Amazonas (LACEN/Amazonas), 69.020-245 Manaus, Amazonas, Brazil
Marcus Lacerda: Heitor Vieira Dourado Tropical Medicine Foundation, 69.040-000 Manaus, Brazil
Liana Blume: Malaria Technical Group, General Coordination for the Monitoring of Zoonoses and Malaria Vector Transmission Diseases, CGZV Department of Immunization and Communicable Diseases, DEIDT, Health Surveillance Secretariat, SVS, Ministry of Health, 70.070-942 Brasília, Brazil
Marinete Póvoa: Parasitology Section, Evandro Chagas Institute-IEC/SVS/MS, 67.030-000 Ananindeua, Pará, Brazil
Giselle Viana: Parasitology Section, Evandro Chagas Institute-IEC/SVS/MS, 67.030-000 Ananindeua, Pará, Brazil

IJERPH, 2020, vol. 18, issue 1, 1-9

Abstract: Histidine-rich proteins 2 and 3 gene ( pfhrp2 and pfhrp3 ) deletions affect the efficacy of rapid diagnostic tests (RDTs) based on the histidine-rich protein 2 (HRP2), compromising the correct identification of the Plasmodium falciparum species. Therefore, molecular surveillance is necessary for the investigation of the actual prevalence of this phenomenon and the extent of the disappearance of these genes in these areas and other South American countries, thus guiding national malaria control programs on the appropriate use of RDTs. This study aimed to evaluate the pfhrp2 and pfhrp3 gene deletion in P. falciparum in endemic areas of the Brazilian Amazon. Aliquots of DNA from the biorepository of the Laboratory of Basic Research in Malaria, Evandro Chagas Institute, with a positive diagnosis for P. falciparum infection as determined by microscopy and molecular assays, were included. Monoinfection was confirmed by nested-polymerase chain reaction assay, and DNA quality was assessed by amplification of the merozoite surface protein-2 gene ( msp2). The pfhrp2 and pfhrp3 genes were amplified using primers for the region between exons 1 and 2 and for all extension of exon 2. Aliquots of DNA from 192 P. falciparum isolates were included in the study, with 68.7% (132/192) from the municipality of Cruzeiro do Sul (Acre) and 31.3% (60/192) from Manaus (Amazonas). Of this total, 82.8% (159/192) of the samples were considered of good quality. In the state of Acre, 71.7% (71/99) showed pfhrp2 gene deletion and 94.9% (94/99) showed pfhrp3 gene deletion, while in the state of Amazonas, 100.0% (60/60) of the samples showed pfhrp2 gene deletion and 98.3% (59/60) showed pfhrp3 gene deletion. Moreover, 79.8% (127/159) of isolates displayed gene deletion. Our findings confirm the presence of a parasite population with high frequencies of pfhrp2 and pfhrp3 gene deletions in the Brazilian Amazon region. This suggests reconsidering the use of HRP2-based RDTs in the Acre and Amazonas states and calls attention to the importance of molecular surveillance and mapping of pfhrp2/pfhrp3 deletions in this area and in other locations in the Amazon region to guarantee appropriate patient care, control and ultimately contribute to achieving P. falciparum malaria elimination.

Keywords: Plasmodium falciparum; rapid diagnostic tests (RDTs); pfhrp2; pfhrp3; gene deletion (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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