Prevalence of Plasmodium Falciparum Infection and Assessment of Histidine-Rich Protein (Pfhrp2 and Pfhrp3) Following Antimalarial Treatment Among Lactating Mothers and Infants in Dutsin-Ma Local Government Area, Katsina State
DOI:
https://doi.org/10.33003/fjs-2026-1021-6335Keywords:
Plasmodium falciparum, Malaria, HRP2, HRP3, RDT, Persistence positivity, PfCRT, Infants, Dutsin-MaAbstract
Malaria Rapid Diagnostic Test antigen persistence complicates treatment monitoring in endemic areas. This longitudinal therapeutic efficacy study assessed HRP2/HRP3 persistent positivity after ACT and Fansidar treatment and identified associated biofactors among 360 participants 180 infants 0-2 years and 180 lactating mothers 19->40 years with microscopy-confirmed Plasmodium falciparum at General Hospital Dutsin-ma. Participants received Artemether-lumefantrine ACT, N=119 (66.1%) or Sulfadoxine-pyrimethamine Fansidar n=61 (33.9%). Follow-up was on Day 1-4, 5-9, 10-14, 15-19 and 20-24. HRP2/HRP3 clearance was assessed by RDT. Biofactors PfCRT K76T, anemia, HIV were analyzed using Chi-square and pearson correlation at p<0.05. At baseline Day 1-4, 100% were HRP2 positive and 91.1% HRP3 positive. Persistence declined progressively; Day 5-9, 99.4% HRP2; Day 10-14, 46.7% infants and 47.2% mothers; Day 15-19, 3.9%; Day 20-24, 0% clearance in both groups. Age significantly influenced clearance p<0.001: infants 0-0.3 years 25.0% vs >2.0 years 83.3% on Day 10-14; mothers 19-21 years 25.8% vs >40 years 85.7%. ACT group had 63.0% persistence vs 18.0% Fansidar on Day 10-14 p<0.001. PfCRT showed strongest correlation with persistence r=0.65, followed by anemia r=0.50 and HIV r=0.45. Despite eventual clearance by Day 20-24, delayed clearance in ACT group is concerning and suggests reduced efficacy or tolerance. Persistence is multifactorial driven by parasite resistance marker and host factors
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