In remote areas of malaria-endemic countries, rapid diagnostic tests (RDTs) have dramatically improved parasitological confirmation of suspected malaria cases, especially when skilled microscopists are not available. This study was designed to determine the frequency of Plasmodium falciparum isolates with histidine-rich protein 2 ( pfhrp2 ) gene deletion as one of the possible factors contributing to the failure of PfHRP2-based RDTs in detecting malaria. A total of 300 blood samples were collected from several health centres in Nyala City, Western Sudan. The performance of PfHRP2-based RDTs in relation to microscopy was examined and the PCR-confirmed samples were investigated for the presence of pfhrp2 gene. A total of 113 out of 300 patients were P. falciparum positive by microscopy. Among them, 93.81% (106 out of 113) were positives by the PfHRP2 RDTs. Seven isolates were identified as false negative on the basis of the RDTs results. Only one isolate (0.9%; 1/113) potentially has pfhrp2 gene deletion. The sensitivity and specificity of PfHRP2-based RDTs were 93.81% and 100%, respectively. The results provide insights into the pfhrp2 gene deletion amongst P. falciparum population from Sudan. However, further studies with a large and systematic collection from different geographical settings across the country are needed.
Background: Malaria is one of the most important infectious diseases in tropical and subtropical regions, and 45% of the population living in areas that suffer from stable malaria transmission in Sudan. The prevalence of symptomatic Plasmodium infection based on microscopy and RDTs is poorly documented in Nyala city. This study was conducted to determine the prevalence of plasmodium infection and molecular identification of plasmodium species in Nyala city, Sudan. Methods: A cross-sectional study was conducted from July 2018 to December 2018 to determine the prevalence of malaria and molecular identification of plasmodium species in Nyala city, Sudan. A total of 300 suspected patients were enrolled in this study. Microscopy and RDTs were performed to estimate the prevalence and nPCR to detect the plasmodium genus and species. Results: Of 300 patients, 113 (37.7%) were positive for malaria. Plasmodium falciparum was the only prevalent species detected amongst the study population. The prevalence of plasmodium infection by microscopy and RDTs was 113 (37.7 %) and 106 (35.3 %), respectively. While PCR result showed prevalence of 47 (47%). Conclusions: This study showed that the only prevalent species identified was P. falciparum, the findings demonstrate no existence of non-falciparum malaria, and children less than five years old were the most infected patients. The diagnostic performance of microscopy was better than RDTs in the diagnosis of malaria infection.
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