HRP2: Transforming Malaria Diagnosis, but with Caveats

Kristin E. Poti, David J. Sullivan, Arjen M. Dondorp, Charles J. Woodrow

Research output: Contribution to journalReview article

Abstract

The major growth in point-of-care malaria diagnosis over the past decade has been based on immunochromatographic malaria rapid diagnostic tests (mRDTs), which generally detect Plasmodium falciparum via its abundant histidine-rich protein 2 (HRP2). Here, we review the discovery and biology of HRP2, as well as the strengths and weaknesses of HRP2-based diagnosis compared with alternative antigens. We highlight recent studies describing HRP2 deletion in Latin America, Eritrea, and possibly other regions, and the methodological challenges of confirming deletion of the pfhrp2 gene. We also discuss the mechanism of persistent HRP2 positivity after effective antimalarial treatment, along with other emerging HRP2-based applications, including detection of submicroscopic malaria and diagnosis of severe malaria.

Original languageEnglish (US)
Pages (from-to)112-126
Number of pages15
JournalTrends in parasitology
Volume36
Issue number2
DOIs
StatePublished - Feb 2020

Fingerprint

Malaria
Eritrea
Point-of-Care Systems
Latin America
Gene Deletion
Antimalarials
Plasmodium falciparum
Routine Diagnostic Tests
histidine-rich proteins
Antigens
Growth

Keywords

  • deletion
  • diagnosis
  • HRP2
  • Plasmodium falciparum
  • rapid diagnostic test
  • severe malaria

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

HRP2 : Transforming Malaria Diagnosis, but with Caveats. / Poti, Kristin E.; Sullivan, David J.; Dondorp, Arjen M.; Woodrow, Charles J.

In: Trends in parasitology, Vol. 36, No. 2, 02.2020, p. 112-126.

Research output: Contribution to journalReview article

Poti, Kristin E. ; Sullivan, David J. ; Dondorp, Arjen M. ; Woodrow, Charles J. / HRP2 : Transforming Malaria Diagnosis, but with Caveats. In: Trends in parasitology. 2020 ; Vol. 36, No. 2. pp. 112-126.
@article{af5654977ab048a98fd95d7c6756a110,
title = "HRP2: Transforming Malaria Diagnosis, but with Caveats",
abstract = "The major growth in point-of-care malaria diagnosis over the past decade has been based on immunochromatographic malaria rapid diagnostic tests (mRDTs), which generally detect Plasmodium falciparum via its abundant histidine-rich protein 2 (HRP2). Here, we review the discovery and biology of HRP2, as well as the strengths and weaknesses of HRP2-based diagnosis compared with alternative antigens. We highlight recent studies describing HRP2 deletion in Latin America, Eritrea, and possibly other regions, and the methodological challenges of confirming deletion of the pfhrp2 gene. We also discuss the mechanism of persistent HRP2 positivity after effective antimalarial treatment, along with other emerging HRP2-based applications, including detection of submicroscopic malaria and diagnosis of severe malaria.",
keywords = "deletion, diagnosis, HRP2, Plasmodium falciparum, rapid diagnostic test, severe malaria",
author = "Poti, {Kristin E.} and Sullivan, {David J.} and Dondorp, {Arjen M.} and Woodrow, {Charles J.}",
year = "2020",
month = "2",
doi = "10.1016/j.pt.2019.12.004",
language = "English (US)",
volume = "36",
pages = "112--126",
journal = "Trends in Parasitology",
issn = "1471-4922",
publisher = "Elsevier Limited",
number = "2",

}

TY - JOUR

T1 - HRP2

T2 - Transforming Malaria Diagnosis, but with Caveats

AU - Poti, Kristin E.

AU - Sullivan, David J.

AU - Dondorp, Arjen M.

AU - Woodrow, Charles J.

PY - 2020/2

Y1 - 2020/2

N2 - The major growth in point-of-care malaria diagnosis over the past decade has been based on immunochromatographic malaria rapid diagnostic tests (mRDTs), which generally detect Plasmodium falciparum via its abundant histidine-rich protein 2 (HRP2). Here, we review the discovery and biology of HRP2, as well as the strengths and weaknesses of HRP2-based diagnosis compared with alternative antigens. We highlight recent studies describing HRP2 deletion in Latin America, Eritrea, and possibly other regions, and the methodological challenges of confirming deletion of the pfhrp2 gene. We also discuss the mechanism of persistent HRP2 positivity after effective antimalarial treatment, along with other emerging HRP2-based applications, including detection of submicroscopic malaria and diagnosis of severe malaria.

AB - The major growth in point-of-care malaria diagnosis over the past decade has been based on immunochromatographic malaria rapid diagnostic tests (mRDTs), which generally detect Plasmodium falciparum via its abundant histidine-rich protein 2 (HRP2). Here, we review the discovery and biology of HRP2, as well as the strengths and weaknesses of HRP2-based diagnosis compared with alternative antigens. We highlight recent studies describing HRP2 deletion in Latin America, Eritrea, and possibly other regions, and the methodological challenges of confirming deletion of the pfhrp2 gene. We also discuss the mechanism of persistent HRP2 positivity after effective antimalarial treatment, along with other emerging HRP2-based applications, including detection of submicroscopic malaria and diagnosis of severe malaria.

KW - deletion

KW - diagnosis

KW - HRP2

KW - Plasmodium falciparum

KW - rapid diagnostic test

KW - severe malaria

UR - http://www.scopus.com/inward/record.url?scp=85076512587&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85076512587&partnerID=8YFLogxK

U2 - 10.1016/j.pt.2019.12.004

DO - 10.1016/j.pt.2019.12.004

M3 - Review article

C2 - 31848119

AN - SCOPUS:85076512587

VL - 36

SP - 112

EP - 126

JO - Trends in Parasitology

JF - Trends in Parasitology

SN - 1471-4922

IS - 2

ER -