title: Genetic variation of pfhrp2 in Plasmodium falciparum isolates from Yemen and the performance of HRP2-based malaria rapid diagnostic test.
abstract: BACKGROUND
  The genetic variation in the Plasmodium falciparum histidine-rich protein 2 (pfhrp2) gene that may compromise the use of pfhrp2-based rapid diagnostic tests (RDTs) for the diagnosis of malaria was assessed in P. falciparum isolates from Yemen.
  
  
  METHODS
  This study was conducted in Hodeidah and Al-Mahwit governorates, Yemen. A total of 622 individuals with fever were examined for malaria by CareStart malaria HRP2-RDT and Giemsa-stained thin and thick blood films. The Pfhrp2 gene was amplified and sequenced from 180 isolates, and subjected to amino acid repeat types analysis.
  
  
  RESULTS
  A total of 188 (30.2%) participants were found positive for P. falciparum by the RDT. Overall, 12 different amino acid repeat types were identified in Yemeni isolates. Six repeat types were detected in all the isolates (100%) namely types 1, 2, 6, 7, 10 and 12 while types 9 and 11 were not detected in any of the isolates. Moreover, the sensitivity and specificity of the used PfHRP2-based RDTs were high (90.5% and 96.1%, respectively).
  
  
  CONCLUSIONS
  The present study provides data on the genetic variation within the pfhrp2 gene, and its potential impact on the PfHRP2-based RDTs commonly used in Yemen. CareStart Malaria HRP2-based RDT showed high sensitivity and specificity in endemic areas of Yemen.
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. wahib_atrosh@yahoo.com.|Department of Microbiology and Parasitology, Faculty of Medicine and Health Sciences University of Aden, Aden, Yemen. wahib_atrosh@yahoo.com.
authors.forename: Wahib M
authors.initials: WM
authors.lastname: Atroosh
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. halmekhlafi@yahoo.com.|Azal National Research Centre, Azal University for Human Development, 447, Sana'a, Yemen. halmekhlafi@yahoo.com.|Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, 1247, Sana'a, Yemen. halmekhlafi@yahoo.com.
authors.forename: Hesham M
authors.initials: HM
authors.lastname: Al-Mekhlafi
authors.affiliation: National Malaria Control programme, Ministry of Public Health and Population, Sana'a, Yemen. badryaman@yahoo.com.
authors.forename: Adel
authors.initials: A
authors.lastname: Al-Jasari
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. hanysady@yahoo.com.
authors.forename: Hany
authors.initials: H
authors.lastname: Sady
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. ahmed_soofi@yahoo.com.
authors.forename: Ahmed K
authors.initials: AK
authors.lastname: Al-Delaimy
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. nabilnesr@yahoo.com.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Nasr
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. saldawaki@gmail.com.
authors.forename: Salwa
authors.initials: S
authors.lastname: Dawaki
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. fafo_1979@yahoo.com.
authors.forename: Awatif M
authors.initials: AM
authors.lastname: Abdulsalam
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. init@um.edu.my.
authors.forename: Init
authors.initials: I
authors.lastname: Ithoi
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. lauyeeling@um.edu.my.
authors.forename: Yee Ling
authors.initials: YL
authors.lastname: Lau
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. fongmy@um.edu.my.
authors.forename: Mun Yik
authors.initials: MY
authors.lastname: Fong
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. joharisurin@um.edu.my.
authors.forename: Johari
authors.initials: J
authors.lastname: Surin
mesh_terms: D000953:Antigens, Protozoan / Q000235:genetics*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D014644:Genetic Variation; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000235:genetics / Q000302:isolation & purification*; D015800:Protozoan Proteins / Q000235:genetics*; D012680:Sensitivity and Specificity; D015006:Yemen
chemical_list: D000953:Antigens, Protozoan; D015800:Protozoan Proteins