P. Falciparum Malaria evolving on Ethiopian border

 

https://rdcu.be/cIwcC

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.