Low Prevalence of Plasmodium falciparum Histidine-Rich Protein 2 and 3 Gene Deletions-A Multiregional Study in Central and West Africa.

parasites carrying deletions of histidine-rich protein 2 and 3 genes, and , respectively, are likely to escape detection via HRP2-based rapid diagnostic tests (RDTs) and, consequently, treatment, posing a major risk to both the health of the infected individual and malaria control efforts. This study assessed the frequency of and -deleted strains at four different study sites in Central Africa (number of samples analyzed: Gabon = 534 and the Republic of Congo = 917) and West Africa (number of samples analyzed: Nigeria = 466 and Benin = 120) using a highly sensitive multiplex qPCR. We found low prevalences for (1%, 0%, 0.03% and 0) and single deletions (0%, 0%, 0.03% and 0%) at all study sites (Gabon, the Republic of Congo, Nigeria and Benin, respectively). Double-deleted were only found in Nigeria in 1.6% of all internally controlled samples. The results of this pilot investigation do not point towards a high risk for false-negative RDT results due to / deletions in Central and West African regions. However, as this scenario can change rapidly, continuous monitoring is essential to ensure that RDTs remain a suitable tool for the malaria diagnostic strategy.