<i>Plasmodium falciparum</i> Histidine-Rich Protein 2 and 3 Gene Deletions in Strains from Nigeria, Sudan, and South Sudan

Abstract Deletion of histidine-rich protein genes pfhrp2/3 in Plasmodium falciparum causes infections to go undetected by HRP2-based malaria rapid diagnostic tests. We analyzed P. cases imported Australia (n = 210, collected 2010–2018) for their status. detected gene deletions patients from 12 25 countries. found >10% pfhrp2-deletion levels those Nigeria (13.3%, n 30), Sudan (11.2%, 39), and South (17.7%, 17) low pfhrp3 deletion (3.6%) (5.9%). No parasites with double were detected. Microsatellite typing Nigeria, Sudan, revealed relatedness among gene-deleted parasites, indicating independent emergences. The proportions signify a risk false-negative HRP2-RDT results. This study’s findings warrant surveillance determine whether the prevalence justifies switching tests Sudan.