Case Report: A Case of Plasmodium falciparum hrp2 and hrp3 Gene Mutation in Bangladesh

Abstract

Several species of <i>Plasmodium</i> are responsible for causing malaria in humans. Proper diagnoses are crucial to case management, because severity and treatment varies between species. Diagnoses can be made using rapid diagnostic tests (RDTs), which detect <i>Plasmodium</i> proteins. <i>Plasmodium falciparum</i> causes the most virulent cases of malaria, and <i>P. falciparum</i> histidine-rich protein 2 (PfHRP2) is a common target of falciparum malaria RDTs. Here we report a case in which a falciparum malaria patient in Bangladesh tested negative on PfHRP2-based RDTs. The negative results can be attributed to a deletion of part of the <i>pfhrp2</i> gene and frameshift mutations in both <i>pfhrp2</i> and <i>pfhrp3</i> gene. This finding may have implications for malaria diagnostics and case management in Bangladesh and other regions of South Asia.