Histidine-rich protein 2- (HRP2-) based rapid diagnostic tests (RDTs) are widely used to detect Plasmodium falciparum in sub-Saharan Africa. Reports of parasites with pfhrp2 and/or pfhrp3 (pfhrp2/3) gene deletions in Africa raise concerns about the long-term viability of HRP2-based RDTs. We evaluated changes in pfhrp2/3 deletion prevalence over time using a 2018-2021 longitudinal study of 1,635 enrolled individuals in Kinshasa Province, Democratic Republic of the Congo (DRC). Samples collected during biannual household visits with ≥ 100 parasites/μL by quantitative real-time PCR were genotyped using a multiplex real-time PCR assay. Among 2,726 P. falciparum PCR-positive samples collected from 993 participants during the study period, 1,267 (46.5%) were genotyped. No pfhrp2/3 deletions or mixed pfhrp2/3-intact and -deleted infections were identified in our study. Pfhrp2/3-deleted parasites were not detected in Kinshasa Province; ongoing use of HRP2-based RDTs is appropriate.

The authors have declared no competing interest.

This study was funded by R01AI132547 to JJJ and RRD, with partial support from R01AI129812 to AKT, R01AI139520 to JAB and a supplement to RF, T32AI070114 to KB, K24AI134990 to JJJ, and an ASTMH/Burroughs-Wellcome Fund award to JBP.

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Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethic committee/IRB of the University of North Carolina-Chapel Hill gave ethical approval for this work. Ethic committee/IRB of the Kinshasa School of Public Health gave ethical approval for this work.

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All data produced in the present study are available upon reasonable request to the authors.