UMass Chan Medical School Faculty Publications

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Department of Medicine

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Amino Acids, Peptides, and Proteins | Diagnosis | Genetics and Genomics | Health Services Administration | Immunology and Infectious Disease | Infectious Disease | International Public Health | Parasitic Diseases | Parasitology | Population Biology


Malaria diagnostic testing in Africa is threatened by Plasmodium falciparum parasites lacking histidine-rich protein 2 (pfhrp2) and 3 (pfhrp3) genes. Among 12,572 subjects enrolled along Ethiopia’s borders with Eritrea, Sudan, and South Sudan and using multiple assays, we estimate HRP2-based rapid diagnostic tests would miss 9.7% (95% CI 8.5-11.1) of falciparum malaria cases due to pfhrp2 deletion. Established and novel genomic tools reveal distinct subtelomeric deletion patterns, well-established pfhrp3 deletions, and recent expansion of pfhrp2 deletion. Current diagnostic strategies need to be urgently reconsidered in Ethiopia, and expanded surveillance is needed throughout the Horn of Africa.


Infectious Diseases, hrp2, hrp3, malaria, molecular inversion probe, genomics, deletion, evolution, Ethiopia

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medRxiv 2021.01.26.21250503; doi: Link to preprint on medRxiv


This article is a preprint. Preprints are preliminary reports of work that have not been certified by peer review.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.