title: Persistence of Plasmodium falciparum HRP-2 in successfully treated acute falciparum malaria.
abstract: The potential for Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) dipstick tests to predict antimalarial treatment failure was investigated in a prospective study in Thailand of 38 patients admitted with severe malaria and 54 hospitalized with uncomplicated P. falciparum infections. Of these, 40 had subsequent recrudescence of their infections. Overall, 89% of patients with severe malaria and 61% of patients with uncomplicated malaria had positive PfHRP-2 dipstick tests for > 2 weeks following the start of treatment. Persistence was correlated positively with admission parasite counts, PfHRP-2 intensity scores and disease severity. PfHRP-2 tests which remained positive for > 2 weeks and PfHRP-2 reactive intensity scores on admission, at day 7 and day 14 did not predict treatment failure independent of admission parasitaemia. Freezing and thawing the blood samples did not significantly affect PfHRP-2 results tested by the dipstick technique. The PfHRP-2 dipstick test provides a useful indicator of recent severe malaria, but does not predict the therapeutic response.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok 10400, Thailand.
authors.forename: M
authors.initials: M
authors.lastname: Mayxay
authors.forename: S
authors.initials: S
authors.lastname: Pukrittayakamee
authors.forename: K
authors.initials: K
authors.lastname: Chotivanich
authors.forename: S
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: N J
authors.initials: NJ
authors.lastname: White
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D015925:Cryopreservation; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis*; D011933:Reagent Kits, Diagnostic; D012008:Recurrence; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D017211:Treatment Failure; D000099053:Histidine-Rich Glycoprotein
chemical_list: D000962:Antimalarials; D011506:Proteins; D011933:Reagent Kits, Diagnostic; D000099053:Histidine-Rich Glycoprotein