@article{Watson:2017:10.7554/eLife.25008,
author = {Watson, O and Slater, HC and Verity, R and Parr, JB and Mwandagalirwa, MK and Tshefu, A and Meshnick, SR and Ghani, AC},
doi = {10.7554/eLife.25008},
journal = {eLife},
title = {Modelling the drivers of the spread of Plasmodium falciparum hrp2 gene deletions in sub-Saharan Africa},
url = {http://dx.doi.org/10.7554/eLife.25008},
volume = {6},
year = {2017}
}

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TY  - JOUR
AB  - Rapid diagnostic tests (RDTs) have transformed malaria diagnosis. The most prevalent P. falciparum RDTs detect histidine-rich protein 2 (PfHRP2). However, pfhrp2 gene deletions yielding false-negative RDTs, first reported in South America in 2010, have been confirmed in Africa and Asia. We developed a mathematical model to explore the potential for RDT-led diagnosis to drive selection of pfhrp2-deleted parasites. Low malaria prevalence and high frequencies of people seeking treatment resulted in the greatest selection pressure. Calibrating our model against confirmed pfhrp2-deletions in the Democratic Republic of Congo, we estimate a starting frequency of 6% pfhrp2-deletion prior to RDT introduction. Furthermore, the patterns observed necessitate a degree of selection driven by the introduction of PfHRP2-based RDT-guided treatment. Combining this with parasite prevalence and treatment coverage estimates, we map the model-predicted spread of pfhrp2-deletion, and identify the geographic regions in which surveillance for pfhrp2-deletion should be prioritised.
AU  - Watson,O
AU  - Slater,HC
AU  - Verity,R
AU  - Parr,JB
AU  - Mwandagalirwa,MK
AU  - Tshefu,A
AU  - Meshnick,SR
AU  - Ghani,AC
DO  - 10.7554/eLife.25008
PY  - 2017///
SN  - 2050-084X
TI  - Modelling the drivers of the spread of Plasmodium falciparum hrp2 gene deletions in sub-Saharan Africa
T2  - eLife
UR  - http://dx.doi.org/10.7554/eLife.25008
UR  - http://hdl.handle.net/10044/1/50471
VL  - 6
ER  - 

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