Persistence of Plasmodium falciparum HRP-2 in successfully treated acute falciparum malaria

Trans R Soc Trop Med Hyg. Mar-Apr 2001;95(2):179-82. doi: 10.1016/s0035-9203(01)90156-7.


The potential for Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) dipstick tests to predict antimalarial treatment failure was investigated in a prospective study in Thailand of 38 patients admitted with severe malaria and 54 hospitalized with uncomplicated P. falciparum infections. Of these, 40 had subsequent recrudescence of their infections. Overall, 89% of patients with severe malaria and 61% of patients with uncomplicated malaria had positive PfHRP-2 dipstick tests for > 2 weeks following the start of treatment. Persistence was correlated positively with admission parasite counts, PfHRP-2 intensity scores and disease severity. PfHRP-2 tests which remained positive for > 2 weeks and PfHRP-2 reactive intensity scores on admission, at day 7 and day 14 did not predict treatment failure independent of admission parasitaemia. Freezing and thawing the blood samples did not significantly affect PfHRP-2 results tested by the dipstick technique. The PfHRP-2 dipstick test provides a useful indicator of recent severe malaria, but does not predict the therapeutic response.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antimalarials / therapeutic use
  • Cryopreservation
  • Humans
  • Malaria, Falciparum / diagnosis*
  • Malaria, Falciparum / drug therapy
  • Prospective Studies
  • Proteins / analysis*
  • Reagent Kits, Diagnostic
  • Recurrence
  • Sensitivity and Specificity
  • Specimen Handling
  • Treatment Failure


  • Antimalarials
  • Proteins
  • Reagent Kits, Diagnostic
  • histidine-rich proteins