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Table 1 WHO protocol and recommended methods for investigating pfhrp2 gene deletion [7]

From: Systematic review of the status of pfhrp2 and pfhrp3 gene deletion, approaches and methods used for its estimation and reporting in Plasmodium falciparum populations in Africa: review of published studies 2010–2019

Area of assessment

WHO protocol recommendation

Study design

Cross-sectional (survey)

Participants

Symptomatic with fever (axillary temperature of > 37.5 °C)

Study sites

Distribution of sites in wide range of epidemiological settings; low, moderate and high transmission should be considered

Size of the study

At least 370 individuals enrolled from 10 randomly selected facilities per survey domain or region is recommended

Double deletion (pfhrp2 and pfhrp3) versus pfhrp2 Only

Protocol recommends investigation of pfhrp2 and pfhrp3 double deletions as opposed to pfhrp2 gene deletion alone

Flanking genes

There is no restriction on the inclusion of the upstream and downstream flanking genes. It remains optional only for characterization of sub-telomeric deletions

Minimum Laboratory Methods Required for confirmation of pfhrp2/3 gene deletions

Suspected Sample should be HRP2 RDT− and Microscopy+ or HRP2 RDT− and Pf-pLDH RDT+  (only discordant samples should be suspected), Confirmation of P. falciparum infection by DNA PCR, demonstration of absence of pfhrp2/3 genes by gene specific PCR and demonstration of presence of single copy genes MSP1 and MSP2