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dc.contributor.authorManning, Laurens
dc.contributor.authorLaman, Moses
dc.contributor.authorStanisic, Danielle
dc.contributor.authorRosanas-Urgell, Anna
dc.contributor.authorBona, Cathy
dc.contributor.authorTeine, David
dc.contributor.authorSiba, Peter
dc.contributor.authorMueller, Ivo
dc.contributor.authorM.E. Davis, Timothy
dc.description.abstractBackground. In areas of unstable malaria transmission, plasma Plasmodium falciparum histidine-rich protein 2 (PfHRP-2) concentrations parallel total parasite biomass and thus infection severity. However, where transmission is more intense, plasma PfHRP-2 might not reliably predict complications and mortality. Methods. As part of a prospective case-control study of severe pediatric illness in Madang, Papua New Guinea, we recruited 220 children aged 6 months to 10 years with severe falciparum malaria, 48 with uncomplicated malaria, and 139 healthy controls. Groups were matched by age, sex, and province of parental birth. Plasma PfHRP-2 levels were quantified by validated immunoassay. Results. Detectable plasma PfHRP-2 concentrations were present in 21 healthy controls (15.1%). Although plasma PfHRP-2 levels were higher in the children with clinical malaria (P < .001), there was no difference between those with uncomplicated and severe infections (median, 584 and 456 ng/mL, respectively [interquartile range, 77-1114 and 113-1113 ng/mL, respectively]; P = .43). Log parasitemia, hemoglobin, log plasma bilirubin, and plasma creatinine levels were independently associated with plasma PfHRP-2 levels in multiple regression analysis (P = .014), but coma, blood lactate level, and plasma bicarbonate level were not. The 1 severely ill child who died had a plasma PfHRP-2 concentration of 483 ng/mL, close to the group median. Conclusions. The clinical and prognostic utility of plasma PfHRP-2 concentrations depends on the epidemiologic circumstances. In areas of intense malaria transmission, plasma PfHRP-2 reflects recent as well as present infections.
dc.publisherOxford University Press
dc.publisher.placeUnited States
dc.relation.ispartofjournalClinical Infectious Diseases
dc.subject.fieldofresearchBiological sciences
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.titlePlasma Plasmodium falciparum Histidine-Rich Protein-2 Concentrations Do Not Reflect Severity of Malaria in Papua New Guinean Children
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorStanisic, Danielle

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