{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:42:42Z","timestamp":1773013362790,"version":"3.50.1"},"reference-count":66,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":289,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      parasite species are the causative agents of malaria, which affects populations worldwide. Rapid diagnostic tests (RDTs), microscopy, and molecular methods have been used to diagnose the disease. HRP2 antigens are unique to\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      , while RDTs can detect lactate dehydrogenase, aldolase, and HRP3. Nevertheless, PfHRP2\u2010based RDTs may produce false\u2010negative results if the parasite\u2019s PfHRP2\/3 genes are deleted. This study is necessary because there is currently no compiled evidence\u2010based information regarding PfHRP2\/3 gene deletion in Ethiopia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Primary research articles on PfHRP2\/3 gene deletions (2000\u20132025) were retrieved from PubMed, Science Direct, and Google Scholar. Eligible studies were systematically searched between May 3 2025, and June 2, 2025. The quality of the included studies was assessed using the Newcastle\u2013Ottawa Scale. Data analysis was performed using STATA Version 17, employing a random effects model. Heterogeneity among studies was evaluated using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      test. To assess publication bias, Begg\u2019s and Egger\u2019s tests were conducted along with funnel plot symmetry analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 932 studies were initially identified, among these 18 studies were selected for full\u2010text review. After excluding 7 studies, 11 articles were included in the meta\u2010analysis. The overall pooled prevalence of PfHRP2\/3 gene deletions was 35.64% (95% CI: 21.43, 49.85). Specifically, the pooled prevalence of PfHRP2 and PfHRP3 gene deletions was 8.48% (95% CI: 0.96, 16.01) and 23.74% (95% CI: 12.16, 35.32), respectively, while concurrent deletions of both genes account for 8.14% (95% CI: 0.67, 15.61).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This systematic review and meta\u2010analysis revealed a high prevalence of\n                      <jats:italic>PfHRP2<\/jats:italic>\n                      \/3 gene deletions, highlighting significant challenges to the continued use of PfHRP2\/3\u2010based RDTs in malaria control programs in Ethiopia. Further nationwide surveillance using standardized methodologies is recommended to better understand the extent of these gene deletions and to guide the immediate phasing out of PfHRP2\/3\u2010based RDTs from the national malaria diagnostic algorithm. We also recommend that PCR be considered an essential diagnostic tool in in\u2010vitro diagnosis (IVD).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cjid\/8677211","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T04:51:54Z","timestamp":1760763114000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Prevalence of\n                    <i>Plasmodium falciparum<\/i>\n                    HRP2\/3 Gene Deletions in Ethiopia: Implications for Malaria Diagnosis and Treatment\u2014A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0805-8658","authenticated-orcid":false,"given":"Habtamu","family":"Gebrie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1886-2373","authenticated-orcid":false,"given":"Aberham","family":"Abere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8396-2186","authenticated-orcid":false,"given":"Anteneh","family":"Gashaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behailu Taye","family":"Gebremeskele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeaynmarnesh Asmare","family":"Bukayaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alem","family":"Bayable","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biazin Yenealem","family":"Mekuriaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyob Getaneh","family":"Yimer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abel Desalegn","family":"Demeke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"e_1_2_14_1_2","unstructured":"WHO World Malaria Report 2023."},{"key":"e_1_2_14_2_2","unstructured":"WHO World Malaria Report 2024."},{"key":"e_1_2_14_3_2","unstructured":"EFMOH Ethiopia Malaria Elimination Strategic Plan: 2021-2025 2020."},{"key":"e_1_2_14_4_2","volume-title":"Malaria-Ethiopia","author":"WHO","year":"2024"},{"key":"e_1_2_14_5_2","volume-title":"Master Protocol for Surveillance of pfhrp2\/3 Deletions and Bio Banking to Support Future Research. Geneva","author":"WHO","year":"2020"},{"key":"e_1_2_14_6_2","unstructured":"WHO Good Practices for Selecting and Procuring Rapid Diagnostic Tests for Malaria 2011."},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.15.1.66-78.2002"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.42.6.2694-2700.2004"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022593"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1006\/expr.2000.4557"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/s0031182000057681"},{"key":"e_1_2_14_12_2","doi-asserted-by":"publisher","DOI":"10.1083\/jcb.103.4.1269"},{"key":"e_1_2_14_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.02557-05"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-10-166"},{"key":"e_1_2_14_15_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2005.73.199"},{"key":"e_1_2_14_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0131576"},{"key":"e_1_2_14_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0008091"},{"key":"e_1_2_14_18_2","volume-title":"False-Negative RDT Results and Implications of New Reports of P. falciparum histidine-rich Protein 2\/3 Gene Deletions. Geneva","author":"WHO","year":"2017"},{"key":"e_1_2_14_19_2","doi-asserted-by":"publisher","DOI":"10.7554\/elife.25008"},{"key":"e_1_2_14_20_2","doi-asserted-by":"publisher","DOI":"10.7554\/elife.40339"},{"key":"e_1_2_14_21_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2012.10-0665"},{"key":"e_1_2_14_22_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.18-0137"},{"key":"e_1_2_14_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.09.009"},{"key":"e_1_2_14_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00281-11"},{"key":"e_1_2_14_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2012.09.015"},{"key":"e_1_2_14_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043094"},{"key":"e_1_2_14_27_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-15031-2"},{"key":"e_1_2_14_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-022-04257-9"},{"key":"e_1_2_14_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-022-04097-7"},{"key":"e_1_2_14_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-017-1752-9"},{"key":"e_1_2_14_31_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2403.171723"},{"key":"e_1_2_14_32_2","volume-title":"Response Plan to pfhrp2 Gene Deletions. Geneva","author":"WHO","year":"2018"},{"key":"e_1_2_14_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160"},{"key":"e_1_2_14_34_2","first-page":"1","article-title":"The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in meta-analyses","volume":"2","author":"Peterson J.","year":"2011","journal-title":"Ottawa Hospital Research Institute"},{"key":"e_1_2_14_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_14_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-013-0377-7"},{"key":"e_1_2_14_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-020-00966-4"},{"key":"e_1_2_14_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyn065"},{"key":"e_1_2_14_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0895-4356(01)00377-8"},{"key":"e_1_2_14_40_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_14_41_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-0485"},{"key":"e_1_2_14_42_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-021-03678-2"},{"key":"e_1_2_14_43_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-12-218"},{"key":"e_1_2_14_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2009.12.001"},{"key":"e_1_2_14_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2222-1808(12)60001-2"},{"key":"e_1_2_14_46_2","volume-title":"Extensive Deletion and Sequence Variation of Plasmodium falciparum Histidine Rich Protein 2\/3 (pfhrp2\/3) Genes in Ethiopia: Implication for RDT-based Malaria Diagnosis and Control","author":"Golassa L.","year":"2020"},{"key":"e_1_2_14_47_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-023-01461-4"},{"key":"e_1_2_14_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-024-04904-3"},{"key":"e_1_2_14_49_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2803.211499"},{"key":"e_1_2_14_50_2","doi-asserted-by":"publisher","DOI":"10.7554\/elife.72083"},{"key":"e_1_2_14_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2020.102757"},{"key":"e_1_2_14_52_2","doi-asserted-by":"crossref","unstructured":"FelekeS. M. Emergence and Evolution of Plasmodium falciparum histidine-rich Protein 2 and 3 Deletion Mutant Parasites in Ethiopia [Preprint] 2021.","DOI":"10.1101\/2021.01.26.21250503"},{"key":"e_1_2_14_53_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiae373"},{"key":"e_1_2_14_54_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-021-03629-x"},{"key":"e_1_2_14_55_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/8848997"},{"key":"e_1_2_14_56_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf212"},{"key":"e_1_2_14_57_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-022-04051-7"},{"key":"e_1_2_14_58_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-024-05031-9"},{"key":"e_1_2_14_59_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-023-04562-x"},{"key":"e_1_2_14_60_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.0020057"},{"key":"e_1_2_14_61_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.97.13.6994"},{"key":"e_1_2_14_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijregi.2022.05.006"},{"key":"e_1_2_14_63_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-021-03812-0"},{"key":"e_1_2_14_64_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-019-3090-6"},{"key":"e_1_2_14_65_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/3954717"},{"key":"e_1_2_14_66_2","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1260"}],"container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cjid\/8677211","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cjid\/8677211","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cjid\/8677211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:25:37Z","timestamp":1773008737000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cjid\/8677211"}},"subtitle":[],"editor":[{"given":"Jianhai","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":66,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/cjid\/8677211"],"URL":"https:\/\/doi.org\/10.1155\/cjid\/8677211","archive":["Portico"],"relation":{},"ISSN":["1712-9532","1918-1493"],"issn-type":[{"value":"1712-9532","type":"print"},{"value":"1918-1493","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8677211"}}