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However, reports of\n P. falciparum<\/jats:italic>\n strains lacking\n Pf<\/jats:italic>\n HRP2 and the structurally similar\n Pf<\/jats:italic>\n HRP3 have raised concerns about the utility and reliability of\n Pf<\/jats:italic>\n HRP2-based RDTs. This study investigated the presence of\n P. falciparum<\/jats:italic>\n with\n pfhrp2<\/jats:italic>\n and\/or\n pfhrp3<\/jats:italic>\n gene deletions among infected residents in the Lake Victoria region, Kenya. Four cross-sectional malaria, surveys were conducted in four sites (Suba South, Mfangano, Kibuogi, and Ngodhe) from September 2018 to January 2020.\n P. falciparum<\/jats:italic>\n infections were detected using a\n Pf<\/jats:italic>\n HRP2-based RDT, microscopy, and PCR on 9120 finger-prick blood samples. Samples negative by RDT but positive by PCR were selected for PCR amplification of\n pfmsp1<\/jats:italic>\n and\n pfmsp2<\/jats:italic>\n to confirm the quality and quantity of\n P. falciparum<\/jats:italic>\n DNA. Samples positive for both\n pfmsp1<\/jats:italic>\n and\n pfmsp2<\/jats:italic>\n were included for detection of deletions of exons 1 and 2 in\n pfhrp2<\/jats:italic>\n and\n pfhrp3<\/jats:italic>\n PCR. The multiplicity of infection (MOI) was determined as the higher allele count between\n pfmsp1<\/jats:italic>\n and\n pfmsp2<\/jats:italic>\n . Logistic regression analysis was performed to analyze the association between\n pfhrp2<\/jats:italic>\n and\/or\n pfhrp3<\/jats:italic>\n deletions and demographic and infection variables. Of the 445 RDT-negative and PCR-positive samples, 125 (28.1%) were analyzed for\n pfhrp2<\/jats:italic>\n and\n pfhrp3<\/jats:italic>\n deletions. Single\n pfhrp2<\/jats:italic>\n deletion, single\n pfhrp3<\/jats:italic>\n deletion, and\n pfhrp2\/3<\/jats:italic>\n double deletions were detected in 13 (10.4%), 19 (15.2%), and 36 (28.8%) samples, respectively. Single\n pfhrp2<\/jats:italic>\n deletion was found in all sites while single\n pfhrp3<\/jats:italic>\n deletion was found in all sites except Kibuogi. The majority of samples with\n pfhrp2<\/jats:italic>\n and\/or\n pfhrp3<\/jats:italic>\n deletions were submicroscopic (73.5%), asymptomatic (80.9%), and monoclonal (80.9%). Polyclonal infection was significantly (\n p<\/jats:italic>\n \u2009=\u20090.022) associated with a lower odds of\n pfhrp2\/3<\/jats:italic>\n double deletion, suggesting detection of intact\n pfhrp2\/3<\/jats:italic>\n in mixed infections. We report the presence of\n P. falciparum<\/jats:italic>\n with\n pfhrp2\/pfhrp3<\/jats:italic>\n double deletions among asymptomatic and submicroscopic infections in Kenya. Our findings highlight the need for active monitoring of\n pfhrp2<\/jats:italic>\n and\n pfhrp3<\/jats:italic>\n deletions at the community level to improve malaria detection and control in the region.\n <\/jats:p>","DOI":"10.1186\/s41182-024-00664-7","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T05:44:38Z","timestamp":1734500678000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Plasmodium falciparum with pfhrp2 and pfhrp3 gene deletions in asymptomatic malaria infections in the Lake Victoria region, Kenya"],"prefix":"10.1186","volume":"52","author":[{"given":"Takatsugu","family":"Okai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chim W.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achyut","family":"KC","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Protus","family":"Omondi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Musyoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kongere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Kagaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Okomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard N.","family":"Kanoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutoshi","family":"Kido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Gitaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"664_CR1","unstructured":"World Health Organization, \u201cWorld malaria report 2022,\u201d (2023)."},{"issue":"1","key":"664_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12936-023-04506-5","volume":"22","author":"S Opoku Afriyie","year":"2023","unstructured":"Opoku Afriyie S, Addison TK, Gebre Y, Mutala AH, Antwi KB, Abbas DA, et al. 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Written informed consent was obtained from all study participants or their parents or legal guardians in the case of minors under 16\u00a0years of age. Participants who tested positive for P. falciparum<\/i> by RDT were given antimalarial treatment (artemether\u2013lumefantrine) for free. The data set was anonymized; no personally identifiable information is included in this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"94"}}