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  Table of Contents  
CORRESPONDENCE
Year : 2012  |  Volume : 30  |  Issue : 4  |  Page : 488-489
 

Fragment size polymorphism in Plasmodium falciparum histidine rich proteins among Indian population is a cause for concern in rapid diagnosis of malaria


Department of Epidemiology & Clinical Research, National Institute of Malaria Research, Sector 8, Dwarka, New Delhi, India

Date of Submission10-May-2012
Date of Acceptance20-Jul-2012
Date of Web Publication24-Nov-2012

Correspondence Address:
N Kumar
Department of Epidemiology & Clinical Research, National Institute of Malaria Research, Sector 8, Dwarka, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.103790

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How to cite this article:
Kumar N, Sharma S. Fragment size polymorphism in Plasmodium falciparum histidine rich proteins among Indian population is a cause for concern in rapid diagnosis of malaria. Indian J Med Microbiol 2012;30:488-9

How to cite this URL:
Kumar N, Sharma S. Fragment size polymorphism in Plasmodium falciparum histidine rich proteins among Indian population is a cause for concern in rapid diagnosis of malaria. Indian J Med Microbiol [serial online] 2012 [cited 2019 Jun 16];30:488-9. Available from: http://www.ijmm.org/text.asp?2012/30/4/488/103790


Dear Editor,

Malaria is one of the important vector-borne diseases in India with about 1.5 million confirmed cases reported every year. [1] Rapid diagnostic tests (RDTs) play a key role in its case management by providing early and accurate diagnosis especially in remote areas where the gold standard method, microscopy, is not easily available. Now, several field tests have questioned its sensitivity and reliability at a lower parasitemia. [2] One of the important factors behind variable sensitivity is genetic variability in diagnostic antigens like PfHRP2 and PfHRP3. It has been reported that the Pfhrp2 and Pfhrp3 genes vary in size and sequence between different parasite strains [3] and also affect the RDT sensitivity. [4],[5] In India, it has been also observed during several field tests that the sensitivity and specificity of PfHRP2-based RDTs were variable among different malaria endemic areas especially at lower parasitemia i.e., less than 500 p/μl.

In the present study, a total of 64 P. falciparum isolates were collected from different malaria endemic regions of India. We observed intra- and inter-regional variations in minimum detection limits as well as fragment size of both target genes [Figure 1]. Amplicon size of Pfhrp2 and Pfhrp3 ranged from 577 bp to 1000 bp and 477 bp to 832 bp, respectively. The average minimum detection limit was found to be less in Orissa (62.5 p/μl) and more in Chhattisgarh (295.6 p/μl). These observations led us to conclude that genetic diversity in these diagnostic genes may be a major factor behind the variable sensitivity of RDTs. More studies should be undertaken for the diagnosis of antigens of Indian P. falciparum population so that, the highly polymorphic genes Pfhrp2/Pfhrp3 along with other non-HRP2-based RDTs antigens can be analyzed to improve the malaria rapid diagnostic tests.
Figure 1: Agarose gel electrophoresis showing fragment length variations in Pfhrp2 gene of P. falciparum isolates of India. Lane 1=100 bp marker; Lane 2-14=Two selected samples from each study sites viz. Gujarat, Rajasthan, Maharashtra, Madhya Pradesh, Orissa, Jharkhand and Chhattisgarh; Lane 15=Malaria parasite bank sample.

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 ~ Acknowledgment Top


The author is thankful to Indian Council of Medical Research (ICMR) for the financial support and Dr. Anup Anvikar, Scientist 'D' and Dr. C.R. Pillia, Emeritus Scientist of National Institute of Malaria Research, New Delhi.

 
 ~ References Top

1.National Vector Borne Diseases Control Programme, India. Available from: http://www.nvbdcp.org. [Last accessed on 7 th May 2012].  Back to cited text no. 1
    
2.Ishengoma DS, Francis F, Mmbando BP, Lusingu JP, Magistrado P, Alifrangis M, et al. Accuracy of malaria rapid diagnostic tests in community studies and their impact on treatment of malaria in an area with declining malaria burden in north-eastern Tanzania. Malar J 2011;10:176.  Back to cited text no. 2
[PUBMED]    
3.Rock EP, Marsh K, Saul AJ, Wellems TE, Taylor DW, Maloy WL. Comparative analysis of the Plasmodium falciparum histidine-rich proteins HRP-I, HRP-II and HRP-III in malaria parasites of diverse origin. Parasitology 1987;95:209-27.  Back to cited text no. 3
    
4.Baker J, McCarthy J, Gatton M, Kyle DE, Belizario V, Luchavez J, et al. Genetic diversity of Plasmodium falciparum histidine-rich protein 2 (PfHRP2) and its effect on the performance of PfHRP2-based rapid diagnostic tests. J Infect Dis 2005;192:870-7.  Back to cited text no. 4
[PUBMED]    
5.Mariette N, Barnadas C, Bouchier C, Tichit M, Ménard T. Country-wide assessment of the genetic polymorphism in Plasmodium falciparum and Plasmodium vivax antigens detected with rapid diagnostic tests for malaria. Malar J 2008;7:219.  Back to cited text no. 5
    


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