Thiranut RamuttonIlse Ce HendriksenJuliet Mwanga-AmumpaireGeorge MtoveRasaq OlaosebikanAntoinette K. TshefuMarie A. OnyambokoCorine KaremaKathryn MaitlandErmelinda GomesSamwel GesaseHugh ReyburnKamolrat SilamutKesinee ChotivanichKamoltip PromnaresCaterina I. FanelloLorenz Von SeidleinNicholas Pj DayNicholas J. WhiteArjen M. DondorpMallika ImwongCharles J. WoodrowMahidol UniversityUniversity of OxfordMbarara University of Science and TechnologyNational Institute for Medical Research TangaMedical Research Council Laboratories GambiaKingasani Research CentreMinistry of HealthWellcome Trust Research Laboratories NairobiHospital Central da BeiraLondon School of Hygiene & Tropical MedicinePrince of Songkla UniversityMenzies School of Health Research2018-06-112018-06-112012-08-20Malaria Journal. Vol.11, (2012)147528752-s2.0-84864948627https://repository.li.mahidol.ac.th/handle/123456789/14286Background: Plasmodium falciparum histidine-rich protein PFHRP2 measurement is used widely for diagnosis, and more recently for severity assessment in falciparum malaria. The Pfhrp2 gene is highly polymorphic, with deletion of the entire gene reported in both laboratory and field isolates. These issues potentially confound the interpretation of PFHRP2 measurements. Methods. Studies designed to detect deletion of Pfhrp2 and its paralog Pfhrp3 were undertaken with samples from patients in seven countries contributing to the largest hospital-based severe malaria trial (AQUAMAT). The quantitative relationship between sequence polymorphism and PFHRP2 plasma concentration was examined in samples from selected sites in Mozambique and Tanzania. Results: There was no evidence for deletion of either Pfhrp2 or Pfhrp3 in the 77 samples with lowest PFHRP2 plasma concentrations across the seven countries. Pfhrp2 sequence diversity was very high with no haplotypes shared among 66 samples sequenced. There was no correlation between Pfhrp2 sequence length or repeat type and PFHRP2 plasma concentration. Conclusions: These findings indicate that sequence polymorphism is not a significant cause of variation in PFHRP2 concentration in plasma samples from African children. This justifies the further development of plasma PFHRP2 concentration as a method for assessing African children who may have severe falciparum malaria. The data also add to the existing evidence base supporting the use of rapid diagnostic tests based on PFHRP2 detection. © 2012 Ramutton et al.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.1186/1475-2875-11-276