关键词: Deletions India Meta-analysis Plasmodium falciparum histidine-rich protein 2/3 genes Sub-Saharan Africa Systematic review

Mesh : Africa South of the Sahara Antigens, Protozoan / genetics False Negative Reactions Gene Deletion Genome, Protozoan India Malaria, Falciparum / diagnosis parasitology Plasmodium falciparum / genetics Prevalence Protozoan Proteins / genetics

来  源:   DOI:10.1186/s12936-019-3090-6   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
BACKGROUND: In 2017, nearly 80% of malaria morbidity and mortality occurred in sub-Saharan African (SSA) countries and India. Rapid diagnostic tests (RDTs), especially those targeting histidine-rich protein 2 (PfHRP2) of Plasmodium falciparum, have become an important diagnostic tool in these malaria-endemic areas. However, the chances of RDT-oriented successful treatment are increasingly jeopardized by the appearance of mutants with deletions in pfhrp2 and pfhrp3 genes. This systematic review and meta-analysis determines the prevalence of field P. falciparum isolates with deletion in pfhrp2 and/or pfhrp3 genes and their proportion among false-negative results in the PfHRP2-based RDTs in SSA and India.
METHODS: Eight electronic databases were used for searching potentially relevant publications for the systematic review analysis, wherein the main methodological aspects of included studies were analysed and some missing links in the included studies were identified.
RESULTS: A total of 19 studies were included, 16 from SSA and 3 from India. The pooled prevalence of pfhrp2 deletions was 8 and 5% while 16 and 4% for pfhrp3 gene deletions in Africa and India, respectively. The pooled proportion of pfhrp2 gene deletions found among false negative PfHRP2-based RDTs results was about 27.0 and 69.0% in Africa and India, respectively.
CONCLUSIONS: This review study indicates a relatively high proportion of both pfhrp2/3 genes deletions in P. falciparum isolates and among false-negative malaria cases using PfHRP2-based RDT results in SSA and India. Recently the deletions in pfhrp2/3 genes have also been reported from two African countries (Nigeria and Sudan). This review emphasizes the importance of more extensive studies and standardization of studies addressing the pfhrp2/3 gene deletions in malarious areas.
摘要:
背景:2017年,近80%的疟疾发病率和死亡率发生在撒哈拉以南非洲(SSA)国家和印度。快速诊断测试(RDT),特别是针对恶性疟原虫的富含组氨酸的蛋白2(PfHRP2),已经成为这些疟疾流行地区的重要诊断工具。然而,由于pfhrp2和pfhrp3基因缺失的突变体的出现,越来越危及以RDT为导向的成功治疗的机会。这项系统评价和荟萃分析确定了pfhrp2和/或pfhrp3基因缺失的恶性疟原虫分离株的患病率,以及它们在SSA和印度基于PfHRP2的RDT的假阴性结果中的比例。
方法:使用八个电子数据库搜索潜在相关出版物进行系统评价分析,其中分析了纳入研究的主要方法学方面,并确定了纳入研究中的一些缺失环节。
结果:共纳入19项研究,16来自SSA,3来自印度。在非洲和印度,pfhrp3基因缺失的合并患病率分别为8%和5%,而16%和4%。分别。在非洲和印度,基于PfHRP2的RDT假阴性结果中发现的pfhrp2基因缺失的合并比例约为27.0%和69.0%,分别。
结论:这项综述研究表明,在SSA和印度,使用基于PfHRP2的RDT结果,恶性疟原虫分离株和假阴性疟疾病例中pfhrp2/3基因缺失的比例相对较高。最近,两个非洲国家(尼日利亚和苏丹)也报道了pfhrp2/3基因的缺失。这篇综述强调了更广泛的研究和标准化研究的重要性,这些研究解决了疟疾地区的pfhrp2/3基因缺失。
公众号