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

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

Lindsay L Fox  1 , Terrie E Taylor, Paul Pensulo, Alice Liomba, Ashley Mpakiza, Amanda Varela, Simon J Glover, Mathew J Reeves, Karl B Seydel
Affiliations

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

Lindsay L Fox et al. J Infect Dis. .

Abstract

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.

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Figures

Figure 1.
Figure 1.
Histidine-rich protein 2 (HRP2) concentrations in case and control subjects. The mean concentration in cases (n = 25) was 7838 ng/mL (SD, 2.5 ng/mL). In controls (n = 125), the mean concentration was 421 ng/mL (SD, 9.0 ng/mL). The difference between the 2 was significant (P < .001). Abbreviation: HRP2, histidine-rich protein 2.
Figure 2.
Figure 2.
Receiver operating characteristic curve comparing histidine-rich protein 2 concentrations to clinical deterioration. The area under the curve was 0.925. Abbreviations: AUC, area under the curve; HRP2, histidine-rich protein 2; ROC, receiver operating characteristic curve.
See this image and copyright information in PMC

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