Molecular Surveillance of P. falciparum Histidine Rich Protein 2/3 (pfhrp2/3) Deletions in the Context of Transmission Intensity

Elly Munde of the Hospital and Health Administration Services in Kenya will integrate a multiplex PCR assay into an existing malaria molecular surveillance program to detect a specific variant in the causative malaria parasite Plasmodium falciparum, which is undetectable by most rapid diagnostic tests and is threatening successful disease control. The specific haplotype of concern has a deletion of the genes encoding for histidine-rich proteins 2 and 3 (hrp2/3). Individuals infected with this haplotype produce a false negative result on most diagnostic tests. They will integrate the PCR assay into an ongoing cohort study, and develop statistical analyses to genotype the samples and decision support tools for guiding future intervention strategies. They will also evaluate the emergence and spread of these new haplotypes by genotyping existing samples to determine the effect of previously deployed diagnostic policies on disease control. If successful, they will scale their approach up nationwide.