Malaria journal · 2026
First detection of pfhrp2 and pfhrp3 gene deletions in Niger Republic: a retrospective sub-analysis of biological samples.
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Issa Ibrahima, Hachimou Illa, Sow Djiby, Mahaman Moustapha Lamine, Mamane Sanoussi Kabirou, Idrissa Yacouba, Alpha Diallo Mamadou, Sene Aïta, Mbaye Ndiaye Ibrahima, Bahari-Tohon Zilahatou, Cavros Irene, Mccaffery Jessica, Bineta Deme Awa, Ibrahim Maman Laminou
Аннотация
BACKGROUND: Rapid diagnostic tests (RDTs) based on histidine-rich protein 2 (HRP2) are the main diagnostic tool for malaria in Niger and many countries in sub-Saharan Africa. However, deletions of the P. falciparum hrp2 and hrp3 genes can compromise RDT performance, and pose a threat to diagnostic accuracy. Although these deletions were reported in several regions of Africa, Asia and South America, no molecular data on pfhrp2/3 were previously available for Niger.
METHODS: The present study is a retrospective sub-analysis of biological samples derived from a therapeutic efficacy study (TES) conducted in Niger in 2022. Antigen profiling was performed using a multiplex bead-based assay to identify samples with weak or undetectable HRP2 signal. Species confirmation was conducted by PET-PCR, and pfhrp2/3 exon 2 genotyping was performed using one-step PCR.
RESULTS: Among the 375 P. falciparum mono-infection isolates analyzed, pfhrp2 deletions were found in 3% (11/375; 95% CI 1-5%), pfhrp3 deletions in 11% (41/375; 95% CI 8-14%), and double deletions in 1% (5/375; 95% CI 0-2%). These figures likely represent a conservative estimate, as the true prevalence may be higher due to the antigen pre-screening and the selection bias inherent in the original study design.
CONCLUSIONS: This is the first molecular evidence of Pfhrp2 and Pfhrp3 deletions in P. falciparum in Niger. The observed pfhrp2 deletion rate is a significant molecular finding; however, further evidence is needed to determine if the rate of false-negative RDTs caused by these deletions reaches the 5% threshold set by WHO for a national RDT policy revision.
METHODS: The present study is a retrospective sub-analysis of biological samples derived from a therapeutic efficacy study (TES) conducted in Niger in 2022. Antigen profiling was performed using a multiplex bead-based assay to identify samples with weak or undetectable HRP2 signal. Species confirmation was conducted by PET-PCR, and pfhrp2/3 exon 2 genotyping was performed using one-step PCR.
RESULTS: Among the 375 P. falciparum mono-infection isolates analyzed, pfhrp2 deletions were found in 3% (11/375; 95% CI 1-5%), pfhrp3 deletions in 11% (41/375; 95% CI 8-14%), and double deletions in 1% (5/375; 95% CI 0-2%). These figures likely represent a conservative estimate, as the true prevalence may be higher due to the antigen pre-screening and the selection bias inherent in the original study design.
CONCLUSIONS: This is the first molecular evidence of Pfhrp2 and Pfhrp3 deletions in P. falciparum in Niger. The observed pfhrp2 deletion rate is a significant molecular finding; however, further evidence is needed to determine if the rate of false-negative RDTs caused by these deletions reaches the 5% threshold set by WHO for a national RDT policy revision.