Histidine-rich protein 2 plasma levels predict progression to cerebral malaria in Malawian children with Plasmodium falciparum infection

J Infect Dis. 2013 Aug 1;208(3):500-3. doi: 10.1093/infdis/jit176. Epub 2013 Apr 22.


Some children with uncomplicated malaria progress to cerebral malaria despite appropriate treatment; identifying them in advance might improve their care. The objective of this study was to determine if plasma concentrations of a malaria protein, HRP2 (histidine-rich protein 2) would serve this purpose. Cases and controls were children presenting with uncomplicated malaria; the cases (n = 25) developed cerebral malaria, and the controls (n = 125) did not. Mean plasma HRP2 concentrations were significantly higher in the cases, and an HRP2 cutoff was identified that could predict disease progression (sensitivity and specificity, 88% for each). Quantitative measurements of HRP2 may be a useful screening tool.

Keywords: HRP2; cerebral malaria; malaria diagnostics.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, Protozoan / blood*
  • Biomarkers / blood*
  • Child
  • Disease Progression
  • Humans
  • Malaria, Cerebral / diagnosis*
  • Malaria, Falciparum / complications*
  • Malawi
  • Plasma / chemistry
  • Protozoan Proteins / blood*
  • Sensitivity and Specificity


  • Antigens, Protozoan
  • Biomarkers
  • HRP-2 antigen, Plasmodium falciparum
  • Protozoan Proteins