Have
a look at this interesting article which I came across whilst looking into an
alternative Rapid Diagnostic Testing (RDT) kit for Malaria.
It
seems that Plasmodium Falciparum Malarial parasites are evolving at multiple
sites along Ethiopias’s borders with Sudan and Eritea. As a result these
parasites are escaping detection by RDTs and giving false negative results
which is estimated to be at 9.7% overall and even higher in Tigray and Amhara
regions.
Malaria
RDTs detect antigens produced by Plasmodium parasites including Histidine Rich
Protein 2 (HRP2, parasite Lactate Dehydrogenase (LDH) and Aldolase. The HRP2
methods appear to be more reliable than other methods but deletions in the plasmodium
falciparum histidine protein 2 (pfhrp2) and 3 (pfhrp3) genes, are leading to
strains of malaria giving false negative results.
In
my laboratory, the RDTs are a supplementary test to microscopy, but in Ethiopia
this is very concerning where RDTs are heavily relied upon. An alternative to
the HPR2 RDT method is not easy. The WHO multiple rounds product testing
publication, suggest that the LDH methods are inferior giving poor results. https://www.who.int/publications/i/item/9789241514965
Lack
of high quality microscopy in and PCR means Malaria control and elimination in
Ethiopa will become increasingly difficult if these expanding plasmodium
falciparum strains cannot be detected by RDTs.
