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Volume 29, Number 1—January 2023

Dispatch

Plasmodium falciparum pfhrp2 and pfhrp3 Gene Deletions in Malaria-Hyperendemic Region, South Sudan

Irene Molina-de la Fuente1, María José Sagrado Benito1Comments to Author , Laurence Flevaud, Janet Ousley, Harriet Akello Pasquale, Ahmed Julla, Abdirashid M. Abdi, Buai Tut Chol, Bakri Abubakr, Agustín BenitoComments to Author , Cristian Casademont, Carolina Nanclares, and Pedro Berzosa
Author affiliations: Institute of Health Carlos III, Madrid, Spain (I. Molina-de la Fuente); Alcala University, Madrid (I.M. de la Fuente, A. Benito, P. Berzosa); Médecins Sans Frontières, Barcelona, Spain (M.J.S. Benito, L. Flevaud, C. Casademont, C. Nanclares); Médecins Sans Frontières, New York, New York, USA (J. Ousley); National Malaria Control Program, Ministry of Health, Juba, South Sudan (H.A. Pasquale, A. Julla); Médecins Sans Frontières, Juba (A.M. Abdi, B.T. Chol); Médecins Sans Frontières, Nairobi, Kenya (B. Abubakr); Centro de Investigación Biomedica en Red de Enfermedades Infecciosas, Madrid (A. Benito, P.J.B. Diaz)

Main Article

Table 2

Association of age, sex, MOI, severity of infection, and previous seasonal malaria chemoprophylaxis with pfhrp2 and pfhrp3 deletions in malaria-hyperendemic region, South Sudan*

Characteristic Total no. pfhrp2 deletion
 pfhrp3 deletion
 pfhrp2/3 double deletion
 Wild-type
No. Frequency, % (95% CI) No. Frequency, % (95% CI) No. Frequency, % (95% CI) No. Frequency, % (95% CI)
Age, y
<5 159 28 17.61 (12.03–24.44) 29 18.24 (12.49–24.98) 14 8.81 (4.87–14.25) 117 73.58 (66.02–80.25)
5–14 196 24 12.24 (8.00–17.67) 30 15.31 (10.57–21.12) 10 5.10 (2.47–9.18) 152 77.55 (71.06–83.19)
>14 163 30 18.40 (12.77–25.21) 45 27.61 (20.90–35.14) 15 9.20 (5.24–14.72) 103 63.19 (55.29–70.60)
p value (χ2)
 0.238 (2.874)
0.012 (8.875)
0.261 (2.686)
0.009
Sex
F 271 44 16.24 (12.05–21.18) 60 22.14 (17.34–27.56) 24 8.86 (5.76–12.89) 191 70.48 (64.66–75.84)
M 247 37 14.98 (10.77–20.05) 44 17.81 (13.25–23.17) 15 6.07 (3.44–9.82) 181 73.79 (67.30–78.69)
p value (χ2)
 0.694 (0.154)
0.219 (1.507)
0.231 (1.438)
0.542
MOI
1: monoclonal 116 26 22.41 (15.19–31.09) 37 31.90 (23.55–41.19) 14 12.07 (6.76–19.42) 102 87.93 (80.58–93.24)
>2: Polyclonal 303 43 14.29 (10.54–18.76) 46 15.28 (11.41–19.85) 15 4.98 (2.82–8.09) 288 95.05 (91.97–97.20)
p value (χ2)
 0.001 (9.881)
<0.001 (14.754)
0.010 (6.598)
0.019
Severity
Uncomplicated 472 68 14.41 (11.36–17.90) 82 17.37 (14.06–21.10) 31 6.57 (4.51–9.19) 359 73.56 (71.95–79.84)
Complicated 30 8 26.67 (12.28–45.89) 14 46.67 (28.34–65.67) 5 16.67 (5.64–34.72) 13 43.33
(25.46–62.57)
p value (χ2)
0.087 (2.937)
<0.001 (14.031)
0.051 (3.819)
<0.001
Seasonal malaria chemoprophylaxis for children <5 y
Yes 137 24 17.52 (11.56–24.94) 22 16.06 (10.35–23.24) 11 8.03 (4.08–13.91) 102 74.45 (66.30–81.52)
Not 22 3 13.64 (2.91–34.91) 7 31.82 (13.86–54.87) 3 13.63 (2.91–34.91) 15 68.18 (45.13–86.14)
p value (χ2) 0.652 (0.203)
 0.075 (3.157)
 0.742 (0.389)
 0.720 (0.129)

*Variables were considered categorical variables and the association between them and deletions were assessed using χ2 testing. Deletions for pfhrp2 and pfhrp3 include both single and double deletions. All analyses used a 95% CI and a p value of <0.05 for statistical significance. MOI, multiplicity of infection.

Main Article

1These authors contributed equally to this article.

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