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Although recent studies have reported false negative HRP2 RDT results due to\n                      <jats:italic>pfhrp2<\/jats:italic>\n                      and\n                      <jats:italic>pfhrp3<\/jats:italic>\n                      gene deletions in different countries, there is a paucity of data on the deletions of these genes in Tanzania.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A community-based cross-sectional survey was conducted between July and November 2017 in four regions: Geita, Kigoma, Mtwara and Ruvuma. All participants had microscopy and RDT performed in the field and provided a blood sample for laboratory multiplex antigen detection (for\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      lactate dehydrogenase, aldolase, and\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      HRP2). Samples showing RDT false negativity or aberrant relationship of HRP2 to pan-\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      antigens were genotyped to detect the presence\/absence of\n                      <jats:italic>pfhrp2\/3<\/jats:italic>\n                      genes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of all samples screened by the multiplex antigen assay (n\u2009=\u20097543), 2417 (32.0%) were positive for any\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      antigens while 5126 (68.0%) were negative for all antigens. The vast majority of the antigen positive samples contained HRP2 (2411, 99.8%), but 6 (0.2%) had only pLDH and\/or aldolase without HRP2. Overall, 13 samples had an atypical relationship between a pan-\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      antigen and HRP2, but were positive by PCR. An additional 16 samples with negative HRP2 RDT results but\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      positive by microscopy were also chosen for\n                      <jats:italic>pfhrp2\/3<\/jats:italic>\n                      genotyping. The summation of false negative RDT results and laboratory antigen results provided 35 total samples with confirmed\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      DNA for\n                      <jats:italic>pfhrp2\/3<\/jats:italic>\n                      genotyping. Of the 35 samples, 4 (11.4%) failed to consistently amplify positive control genes;\n                      <jats:italic>pfmsp1<\/jats:italic>\n                      and\n                      <jats:italic>pfmsp2<\/jats:italic>\n                      and were excluded from the analysis. The\n                      <jats:italic>pfhrp2<\/jats:italic>\n                      and\n                      <jats:italic>pfhrp3<\/jats:italic>\n                      genes were successfully amplified in the remaining 31 (88.6%) samples, confirming an absence of deletions in these genes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study provides evidence that\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      parasites in the study area have no deletions of both\n                      <jats:italic>pfhrp2<\/jats:italic>\n                      and\n                      <jats:italic>pfhrp3<\/jats:italic>\n                      genes. Although single gene deletions could have been missed by the multiplex antigen assay, the findings support the continued use of HRP2-based RDTs in Tanzania for routine malaria diagnosis. There is a need for the surveillance to monitor the status of\n                      <jats:italic>pfhrp<\/jats:italic>\n                      2 and\/or\n                      <jats:italic>pfhrp3<\/jats:italic>\n                      deletions in the future.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-020-03459-3","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T05:03:06Z","timestamp":1604466186000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Community-based surveys for Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions in selected regions of mainland Tanzania"],"prefix":"10.1186","volume":"19","author":[{"given":"Catherine","family":"Bakari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gireesh","family":"Subramaniam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine I.","family":"Mandara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercy G.","family":"Chiduo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Rumisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Chacky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Molteni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Mandike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigsbert","family":"Mkude","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritha","family":"Njau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camelia","family":"Herman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas P.","family":"Nace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ally","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatachalam","family":"Udhayakumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caleb K.","family":"Kibet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G.","family":"Nyanjom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Rogier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-3416","authenticated-orcid":false,"given":"Deus S.","family":"Ishengoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"key":"3459_CR1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1128\/CMR.15.1.66-78.2002","volume":"15","author":"A Moody","year":"2002","unstructured":"Moody A. 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