In remote areas of malaria-endemic countries, rapid diagnostic tests (RDTs) have dramatically improved parasitological confirmation of suspected malaria cases, especially when skilled microscopists are not available. This study was designed to determine the frequency of Plasmodium falciparum isolates with histidine-rich protein 2 (pfhrp2) gene deletion as one of the possible factors contributing to the failure of PfHRP2-based RDTs in detecting malaria. A total of 300 blood samples were collected from several health centres in Nyala City, Western Sudan. The performance of PfHRP2-based RDTs in relation to microscopy was examined and the PCR-confirmed samples were investigated for the presence of pfhrp2 gene. A total of 113 out of 300 patients were P. falciparum positive by microscopy. Among them, 93.81% (106 out of 113) were positives by the PfHRP2 RDTs. Seven isolates were identified as false negative on the basis of the RDTs results. Only one isolate (0.9%; 1/113) potentially has pfhrp2 gene deletion. The sensitivity and specificity of PfHRP2-based RDTs were 93.81% and 100%, respectively. The results provide insights into the pfhrp2 gene deletion amongst P. falciparum population from Sudan. However, further studies with a large and systematic collection from different geographical settings across the country are needed.
Functional near-infrared spectroscopy (fNIRS) is a noninvasive functional imaging technique measuring hemodynamic changes including oxygenated (
O
2
Hb
) and deoxygenated (HHb) hemoglobin. Low frequency (LF; 0.01 to 0.15 Hz) band is commonly analyzed in fNIRS to represent neuronal activation. However, systemic physiological artifacts (i.e., nonneuronal) likely occur also in overlapping frequency bands. We measured peripheral photoplethysmogram (PPG) signal concurrently with fNIRS (at prefrontal region) to extract the low-frequency oscillations (LFOs) as systemic noise regressors. We investigated three main points in this study: (1) the relationship between prefrontal fNIRS and peripheral PPG signals; (2) the denoising potential using these peripheral LFOs, and (3) the innovative ways to avoid the false-positive result in fNIRS studies. We employed spatial working memory (WM) and control tasks (e.g., resting state) to illustrate these points. Our results showed: (1) correlation between signals from prefrontal fNIRS and peripheral PPG is region-dependent. The high correlation with peripheral ear signal (i.e.,
O
2
Hb
) occurred mainly in frontopolar regions in both spatial WM and control tasks. This may indicate the finding of task-dependent effect even in peripheral signals. We also found that the PPG recording at the ear has a high correlation with prefrontal fNIRS signal than the finger signals. (2) The systemic noise was reduced by 25% to 34% on average across regions, with a maximum of 39% to 58% in the highly correlated frontopolar region, by using these peripheral LFOs as noise regressors. (3) By performing the control tasks, we confirmed that the statistically significant activation was observed in the spatial WM task, not in the controls. This suggested that systemic (and any other) noises unlikely violated the major statistical inference. (4) Lastly, by denoising using the task-related signals, the significant activation of region-of-interest was still observed suggesting the manifest task-evoked response in the spatial WM task.