Global risk of selection and spread of Plasmodium falciparum histidine-rich protein 2 and 3 gene deletions

Since their first detection in 2010, Plasmodium falciparum malaria parasites lacking the P. falciparum histidine-rich protein 2 gene (pfhrp2) have been observed in 40 of 47 surveyed countries, as documented by the World Health Organization. These genetic deletions reduce detection by the most widely used rapid diagnostic tests, prompting three countries to switch to alternative diagnostics.

Citation:
Watson OJ, Tran TNA, Zupko RJ, Symons T, Thomson R, ……. Rumisha S, Dzianach PA, Hathaway N, …….. Gething P, Ghani A, et al. Global risk of selection and spread of Plasmodium falciparum histidine-rich protein 2 and 3 gene deletions. Nat Med. 2025.

Keywords:
Epidemiology; genetics; antigens; gene deletion; malaria; falciparum; diagnosis; parasitology

Abstract:
Since their first detection in 2010, Plasmodium falciparum malaria parasites lacking the P. falciparum histidine-rich protein 2 gene (pfhrp2) have been observed in 40 of 47 surveyed countries, as documented by the World Health Organization. These genetic deletions reduce detection by the most widely used rapid diagnostic tests, prompting three countries to switch to alternative diagnostics.