Defining the extent and evolution of HRP2 and HRP3 deletions in Ethiopia

Our new work in Nature Micro titled Plasmodium falciparum is evolving to escape malaria rapid diagnostic tests in Ethiopia by Sindew Feleke and Jonathan Parr in large collaboration involving WHO and Ethiopian Public Health  provides a large scale assessment of HRP2 and HRP3 deletions that render parasites invisible to the most common rapid diagnostic tests (RDTs). Co-last author, Ozkan Aydemir, former Brown Assistant Professor, drove the MIP analysis along with Bailey and Hathaway from our group. MIPs tiling across the large scale deletions and flanking genes and sequences allowed us to detect multiple origins for HRP3 deletions and a singular origin for HRP2 deletions that is spreading on the background of the HRP3 deletions. The apparent strength of selection suggests a grave threat to the utility of HRP2-based RDTs the mainstay of diagnosis. A good press article can be found in Ars Technica.