Plasmodium falciparum parasites amongst red blood cells.
Creationist mode: 
We saw yesterday how Creationism's favourite malevolence, the putative intelligent designer responsible for all living organisms and how they adapt, is pulling out all the stops in an effort to combat the success human medical science is having with its anti-COVID-19 vaccines, by designing multiple variants and now tweaking the more successful ones so they can kill even more people and make many more sick.
Now we have news that it is also working hard to maintain the suffering caused by another of its brilliantly malevolent designs - Plasmodium falciparum, the parasitic protozoan that caused malaria.
This is a serious problem for malaria control efforts and a reminder that pathogens are very capable of adapting to survive. Surveillance across the Horn of Africa and alternative malaria diagnostic approaches in affected regions are urgently needed.
In an open access paper, published in Nature Microbiology, a combined team of scientists from the University of North Carolina (UNC) School of Medicine, the World Health Organization, and the Ethiopian Public Health Institute has discovered that the organism has two mutations, in this case, deletion of genes from the genome, or as Creationists would put it, a newly-redesigned genome, that allow it to remain undetected by one of the latest pieces of medical science - the rapid diagnostic test (RDT) used in the 'test-treat-track' strategy by the World Health Organisation (WHO). This means that about 10% of cases remain undetected.Assistant professor Jonathan B. Parr, MD, Co-research supervisor
UNC School of Medicine.
UNC School of Medicine.
The UNC news release explains:
Our work indicates that prhrp3 deletions have arisen independently multiple times over the course of years. We also found signs that RDT-based testing and treatment are driving a recent rise in pfhrp2 deletion mutation prevalence, allowing parasites to escape detection.
We found clear evidence that parasites have recently evolved to escape detection by malaria rapid diagnostic tests along Ethiopia’s borders with Sudan and Eritrea.
False-negative results were common in multiple sites and will lead to misdiagnosis and malaria deaths without intervention.
We found clear evidence that parasites have recently evolved to escape detection by malaria rapid diagnostic tests along Ethiopia’s borders with Sudan and Eritrea.
False-negative results were common in multiple sites and will lead to misdiagnosis and malaria deaths without intervention.
Dr. Jonathan B. Parr MD., Co-research supervisor
Institute for Global Health and Infectious Diseases
UNC School of Medicine
Institute for Global Health and Infectious Diseases
UNC School of Medicine
The research team enrolled 12,572 participants along Ethiopia’s border with Eritrea, Sudan, and South Sudan, using RDTs, PCR diagnostics, an ultrasensitive immunoassay for antigen detection, and next-generation sequencing to find that P. falciparum lacking the genes histidine-rich protein 2 (pfhrp2) and histidine-rich protein 3 (pfhrp3) escape detection by the RDTs and appear to have spread rapidly. In collaboration with Brown University’s Jeffrey A. Bailey, MD, PhD, and Ozkan Aydemir, PhD, the researchers applied a molecular sequencing approach to pinpoint the particular deletion patterns of these genetic mutations.
Creationist mode: 
Creationists who have also been fooled into thinking the Theory of Evolution by Natural Selection is a theory in crisis, because a bunch of religious fundamentalists who don't work in the field and who don't understand the theory or the mechanisms of change over time in species it explains, might like to wonder why that news doesn't seem to have reached this team of expert biomedical scientists. They appear to be in no doubt that the observed increase in the incidence of these mutations is an evolutionary process and the use of these rapid diagnostic tests is the environmental change driving evolution of P. falciparum, exactly as the TOE predicts.
In the abstract to their paper detailing their findings, the team say:
a, Aggregated results from both RDTs, CareStart Pf/Pv (HRP2/Pv-LDH) RDT and SD Bioline Malaria Ag P.f. (HRP2/Pf-LDH) RDT, displayed by region for all P. falciparum infections (n = 2,714). The ‘2 HRP2−, 1 Pf-LDH+’ discordant RDT profile indicates potential infection by pfhrp2/3-deleted P. falciparum. Triangles represent the enrolment sites, including 11 districts and the Kule refugee camp within the Itang district in Gambella. b, Percentage of study participants identified with P. falciparum infection by RDT who had the discordant RDT profile, by district.
AbstractDedicated creationists will be familiar with other changes in P. falciparum in response to the extensive use of antibiotics, to develop resistance to them. This was famously the subject of another book by the inventor of the intelligent [sic] design hoax for the Deception Institute, Michael J. Behe, where he argued that the series of mutations needed for resistance must have been intelligently designed, thus unwittingly portraying the putative intelligent [sic] designer as a malevolent monster intent on defeating the efforts of medical science and continuing to kill millions of people, mostly children, every year. To save his blushes however, Kenneth R. Miller famously demolished Behe's 'arguments', pointing out schoolboy errors, both in his biology and in his maths.
In Africa, most rapid diagnostic tests (RDTs) for falciparum malaria recognize histidine-rich protein 2 antigen. Plasmodium falciparum parasites lacking histidine-rich protein 2 (pfhrp2) and 3 (pfhrp3) genes escape detection by these RDTs, but it is not known whether these deletions confer sufficient selective advantage to drive rapid population expansion. By studying blood samples from a cohort of 12,572 participants enroled in a prospective, cross-sectional survey along Ethiopia’s borders with Eritrea, Sudan and South Sudan using RDTs, PCR, an ultrasensitive bead-based immunoassay for antigen detection and next-generation sequencing, we estimate that histidine-rich protein 2-based RDTs would miss 9.7% (95% confidence interval 8.5–11.1) of P. falciparum malaria cases owing to pfhrp2 deletion. We applied a molecular inversion probe-targeted deep sequencing approach to identify distinct subtelomeric deletion patterns and well-established pfhrp3 deletions and to uncover recent expansion of a singular pfhrp2 deletion in all regions sampled. We propose a model in which pfhrp3 deletions have arisen independently multiple times, followed by strong positive selection for pfhrp2 deletion owing to RDT-based test-and-treatment. Existing diagnostic strategies need to be urgently reconsidered in Ethiopia, and improved surveillance for pfhrp2 deletion is needed throughout the Horn of Africa.
Feleke, Sindew M.; Reichert, Emily N.; Mohammed, Hussein; Brhane, Bokretsion G.; Mekete, Kalkidan; Mamo, Hassen; Petros, Beyene; Solomon, Hiwot; Abate, Ebba; Hennelly, Chris; Denton, Madeline; Keeler, Corinna; Hathaway, Nicholas J.; Juliano, Jonathan J.; Bailey, Jeffrey A.; Rogier, Eric; Cunningham, Jane; Aydemir, Ozkan; Parr, Jonathan B.
Plasmodium falciparum is evolving to escape malaria rapid diagnostic tests in Ethiopia
Nature Microbiology 6, 1289–1299 (2021). DOI: 10.1038/s41564-021-00962-4
Copyright: © 2021 The authors. Published by Springer Nature Ltd.
Open access. Reprinted under a Creative Commons Attribution 4.0 International license (CC BY 4.0)
But now we have another embarrassing mutation in P. falciparum the explanation for which Creationists have to choose, the same as they have to choose between explanations for the frequent mutations in the SARS-CoV-2 virus that causes COVID-19. Is it an example of the pestilential malevolence of their beloved, supposedly omni-benevolent, creator god, or does that creator god get off the hook by blaming it on the perfectly natural but mindless and amoral process, evolution by natural selection?
Incidentally, as though that wasn't bad enough for Creationism, we have here an example of something Creationist dogma insists doesn't happen. We have beneficial (to the parasite) evolution by loss of information - a commonplace thing in parasites. Creationist anti-evolution dogma argues that any mutation must involve a loss of information and a loss of information is always detrimental, therefore mutation can't be part of evolution.
Yet here we are with a mutation that has resulted in the loss of two genes and their absence means P. falciparum is more successful in the prevailing environment!
Creationism also argues that evolution always results in an increase in complexity, ignoring the fact that many parasites have greatly reduced complexity as a result of adaptation to a dependent lifestyle. In this case, the loss of two genes is an advantageous reduction in complexity, i.e, evolution by reduced complexity.
In normal science, an example of a hypothesis being wrong is usually fatal for that hypothesis. Not so in 'creation science' it seems. In 'creation science' inconvenient facts are simply ignored and the hypothesis is retained because it serves some agenda or other which is not related to the truth and greater understanding of the natural world.
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