Detection of Pfhrp-2 gene deletion in Plasmodium falciparum among patients with symptoms of malaria attending selected Primary Health Care Centres in Yola South, Adamawa State, Nigeria

Abstract

Malaria is a major health issue in sub-saharan Africa, causing over 300,000 deaths annually in Nigeria, mostly due to Plasmodium falciparum. The pfhrp-2 gene is a marker used for diagnosis of malaria but some strains lack it which makes detection and treatment harder, especially in low-income settings. This study aimed to detect pfhrp-2 gene deletion in Plasmodium falciparum among patients with symptoms of malaria attending selected Primary Health Care Centres in Yola South, Adamawa State, Nigeria. A cross-sectional study was conducted, two(2) ml of veinous blood sample was obtained from 200 patients presenting with symptoms of malaria. The samples were examine by microscopy and rapid diagnostic test(RDT). Samples that tested positive by microscopy but negative by RDT(5) were analysed using PCR assay to confirm the presence of Plasmodium falciparum 18SrRNA and pfhrp-2 gene. Of the 200 samples, 65(32.5%) were positive for Plasmodium falciparum by Microscopy. However, only 50(25%) were positive by rapid diagnostic test. The highest parasitaemia level recorded was 12,000 parasite/microlitre, while the least was 400 parasite/microlitre. The sociodemographic factors considered in this study were not significantly associated with Plasmodium infection (p>0.05). However, patients who presented fever, headache,nausea and vomiting, and muscle aches were more at risk of Plasmodium infection (OR>1). Individuals who had bushes around their homes, lived in areas with blood drainage and kept their doors open at dusk and dawn and do not use insecticide sprays were at risk of Plasmodium infection (OR>1). The study revealed that the genes was present in 80%of the blood samples and 20% of the samples lacked the gene. This study provides evidence of the of the Pfhrp-2 gene deletion since some of the samples lacked the pfhrp-2 gene in Plasmodium falciparum among patients attending selected primary health care centres in Yola South. Further research is needed to understand the implications of this gene deletion and to develop more reliable diagnostic tools.

Keywords: Malaria, Plasmodium falciparum, Gene deletion, Rapid Diagnostic Test.