1
|
Pian H, Wang H, Wang H, Li Z. Dual CRISPR/Cas13a Cascade Strand Displacement-Triggered Transcription for Point-of-Care Detection of Plasmodium in Asymptomatic Malaria. Anal Chem 2024; 96:7524-7531. [PMID: 38695755 DOI: 10.1021/acs.analchem.4c00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
Asymptomatic infections of Plasmodium parasites are major obstacles to malaria control and elimination. A sensitive, specific, and user-friendly method is urgently needed for point-of-care (POC) Plasmodium diagnostics in asymptomatic malaria, especially in resource-limited settings. In this work, we present a POC method (termed Cas13a-SDT) based on the cascade sequence recognition and signal amplification of dual Cas13a trans-cleavage and strand displacement-triggered transcription (SDT). Cas13a-SDT not only achieves exceptional specificity in discriminating the target RNA from nontarget RNAs with any cross-interaction but also meets the sensitivity criterion set by the World Health Organization (WHO) for effective malaria detection. Remarkably, this novel method was successfully applied to screen malaria in asymptomatic infections from clinical samples. The proposed method provides a user-friendly and visually interpretable output mode while maintaining high accuracy and reliability comparable to RT-PCR. These excellent features demonstrate the significant potential of Cas13a-SDT for POC diagnosis of Plasmodium infections, laying a vital foundation for advancing malaria control and elimination efforts.
Collapse
Affiliation(s)
- Hongru Pian
- Beijing Key Laboratory for Bioengineering and Sensing Technology, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Hui Wang
- Beijing Key Laboratory for Bioengineering and Sensing Technology, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Honghong Wang
- Beijing Key Laboratory for Bioengineering and Sensing Technology, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Zhengping Li
- Beijing Key Laboratory for Bioengineering and Sensing Technology, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing 100083, China
| |
Collapse
|
2
|
Choosang K, Boonsilp S, Kritsiriwuthinan K, Chumchuang P, Thanacharoensakun N, Saai A, Pongparit S. A dot-blot ELISA preliminary evaluation using PvMSP1-42 recombinant protein as antigen for serological diagnosis of Plasmodium vivax infection in Thailand. Eur J Microbiol Immunol (Bp) 2024; 14:202-209. [PMID: 38427079 PMCID: PMC11097782 DOI: 10.1556/1886.2024.00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
Plasmodium vivax is the most prevalent cause of malaria in Thailand and is predominant in malarial endemic areas worldwide. P. vivax infection is characterized by low parasitemia, latent liver-stage parasites, or asymptomatic infections leading to underreported P. vivax cases. These are significant challenges for controlling and eliminating P. vivax from endemic countries. This study developed and evaluated a dot-blot enzyme-linked immunosorbent assay (ELISA) using PvMSP1-42 recombinant antigen for serological diagnosis based on the detection of antibodies against P. vivax. The optimal PvMSP1-42 concentration and dilutions of anti-human IgG horseradish peroxidase (HRP)-conjugated antiserum were tested on 88 serum samples from P. vivax, Plasmodium falciparum and bacterial infection, including healthy individuals. A cut-off titer of 1:800 produced optimal values for sensitivity and specificity of 90.9 and 98.2%, respectively, with an accuracy of 95.5%. The positive and negative predictive values were 96.8 and 94.7% respectively. The results from microscopic examination and dot-blot ELISA showed strong agreement with the 0.902 kappa index. Thus, the dot-blot ELISA using PvMSP1-42 antigen provided high sensitivity and specificity suitable for serodiagnosis of P. vivax infection. The test is a simple and quick diagnostic assay suitable for field testing as it does not require specific equipment or particular skills.
Collapse
Affiliation(s)
- Kantima Choosang
- Faculty of Medical Technology, Rangsit University, Pathumthani, 12000, Thailand
| | - Siriphan Boonsilp
- Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Dusit, Bangkok, Thailand
| | | | - Palin Chumchuang
- Faculty of Medical Technology, Rangsit University, Pathumthani, 12000, Thailand
| | | | | | - Sawanya Pongparit
- Faculty of Medical Technology, Rangsit University, Pathumthani, 12000, Thailand
| |
Collapse
|
3
|
Khan MA, Afshan K, Firasat S, Abbas M, Sargison ND, Betson M, Chaudhry U. Validation of deep amplicon sequencing of Dicrocoelium in small ruminants from Northern regions of Pakistan. PLoS One 2024; 19:e0302455. [PMID: 38683822 PMCID: PMC11057770 DOI: 10.1371/journal.pone.0302455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/03/2024] [Indexed: 05/02/2024] Open
Abstract
Dicrocoelium lancet flukes cause significant production loss in ruminant livestock. Although co-infection with multiple Dicrocoelium species within a host is common, techniques for studying the composition of these complex parasite communities are lacking. The pathogenicity, epidemiology, and therapeutic susceptibility of different helminth species vary, and little is known about the interactions that take place between co-infecting species and their hosts. Here, we describe the first applicationof metabarcoding deep amplicon sequencing method to studythe Dicrocoelium species in sheep and goats. First, rDNA ITS-2 sequences of four Dicrocoelium species (Dicrocoelium dendriticum, Dicrocoelium hospes, Dicrocoelium orientalis, and Dicrocoelium chinensis) were extracted from the NCBI public database. Phylogenetic analysis revealed separate clades of Dicrocoelium species; hence, molecular differentiation between each species is possible in co-infections. Second, 202 flukes belonging to seventeen host populations (morphologically verified as belonging to the Dicrocoelium genus) were evaluated to determine the deep amplicon sequencing read threshold of an individual fluke for each of the four species. The accuracy of the method in proportional quantification of samples collected from single hosts was further assessed. Overall, 198 (98.01%) flukes were confirmed as D. dendriticum and 1.98% produced no reads. The comparison of genetic distances between rDNA ITS-2 revealed 86% to 98% identity between the Dicrocoelium species. Phylogenetic analysis demonstrated a distinct clustering of species, apart from D. orientalis and D. chinensis, which sit very close to each other in a single large clade whereas D. hospes and D. dendriticum are separated into their own clade. In conclusion each sample was identified as D. dendriticum based on the proportion of MiSeq reads and validated the presence of this group of parasites in the Gilgit Baltistan and Khyber Pakhtunkhwa provinces of Pakistan. The metabarcoding deep amplicon sequencing technology and bioinformatics pathway have several potential applications, including species interactions during co-infections, identifying the host and geographical distribution of Dicrocoelium in livestock, drug therapy response evaluation and understanding of the emergence and spread of drug resistance.
Collapse
Affiliation(s)
- Muhammad Asim Khan
- Faculty of Biological Sciences, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Kiran Afshan
- Faculty of Biological Sciences, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sabika Firasat
- Faculty of Biological Sciences, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Abbas
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Neil D. Sargison
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | - Martha Betson
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Umer Chaudhry
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
- School of Veterinary Medicine, St. George’s University True Blue, St. George’s Grenada, Caribbean
| |
Collapse
|
4
|
Balmith M, Basson C, Brand SJ. The Malaria Burden: A South African Perspective. J Trop Med 2024; 2024:6619010. [PMID: 38434493 PMCID: PMC10907104 DOI: 10.1155/2024/6619010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/30/2024] [Accepted: 02/14/2024] [Indexed: 03/05/2024] Open
Abstract
Malaria is a deadly disease caused by protozoan pathogens of the Plasmodium parasite. Transmission to humans occurs through the bite of an infected female Anopheles mosquito. According to the World Health Organization (WHO), an estimated 247 million cases of malaria were recorded worldwide in 2021, with approximately 619 000 malaria deaths. The initial signs of malaria can be mild and challenging to diagnose due to the signs and symptoms being similar to those of other illnesses. The malaria burden remains largely concentrated in the WHO sub-Saharan African region and has been recognised as a significant contributor to morbidity and mortality. This review aims to contribute to the existing knowledge on malaria in South Africa, a region within sub-Saharan Africa, focusing on the epidemiology and life cycle of the malaria parasite as well as diagnostic approaches for detecting malaria. In addition, nonpharmacological and pharmacological interventions for treating and preventing malaria infections will also be discussed herein. While there has been a significant reduction in the global burden of this disease, malaria remains a public health issue in South Africa. As such, the implementation of effective preventative measures and strategies, early diagnosis, and appropriate treatment regimens are crucial to reducing the malaria burden in South Africa.
Collapse
Affiliation(s)
- Marissa Balmith
- Department of Pharmacology, School of Medicine, University of Pretoria, Pretoria, South Africa
| | - Charlise Basson
- Department of Physiology, School of Medicine, University of Pretoria, Pretoria, South Africa
| | - Sarel J. Brand
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa
| |
Collapse
|
5
|
Calderaro A, Piccolo G, Chezzi C. The Laboratory Diagnosis of Malaria: A Focus on the Diagnostic Assays in Non-Endemic Areas. Int J Mol Sci 2024; 25:695. [PMID: 38255768 PMCID: PMC10815132 DOI: 10.3390/ijms25020695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/26/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Even if malaria is rare in Europe, it is a medical emergency and programs for its control should ensure both an early diagnosis and a prompt treatment within 24-48 h from the onset of the symptoms. The increasing number of imported malaria cases as well as the risk of the reintroduction of autochthonous cases encouraged laboratories in non-endemic countries to adopt diagnostic methods/algorithms. Microscopy remains the gold standard, but with limitations. Rapid diagnostic tests have greatly expanded the ability to diagnose malaria for rapid results due to simplicity and low cost, but they lack sensitivity and specificity. PCR-based assays provide more relevant information but need well-trained technicians. As reported in the World Health Organization Global Technical Strategy for Malaria 2016-2030, the development of point-of-care testing is important for the improvement of diagnosis with beneficial consequences for prompt/accurate treatment and for preventing the spread of the disease. Despite their limitations, diagnostic methods contribute to the decline of malaria mortality. Recently, evidence suggested that artificial intelligence could be utilized for assisting pathologists in malaria diagnosis.
Collapse
Affiliation(s)
- Adriana Calderaro
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (G.P.); (C.C.)
| | | | | |
Collapse
|
6
|
Wei H, Li J, Liu Y, Cheng W, Huang H, Liang X, Huang W, Lin L, Zheng Y, Chen W, Wang C, Chen W, Xu G, Wei W, Chen L, Zeng Y, Lu Z, Li S, Lin Z, Wang J, Lin M. Rapid and Ultrasensitive Detection of Plasmodium spp. Parasites via the RPA-CRISPR/Cas12a Platform. ACS Infect Dis 2023; 9:1534-1545. [PMID: 37493514 DOI: 10.1021/acsinfecdis.3c00087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Microscopic examination of thick and thin blood smears stained with Giemsa dye is considered the primary diagnostic tool for the confirmation and management of suspected clinical malaria. However, detecting gametocytes is relatively insensitive, particularly in asymptomatic individuals with low-density Plasmodium infections. To complement existing diagnostic methods, a rapid and ultrasensitive point-of-care testing (POCT) platform for malaria detection is urgently needed and necessary. A platform based on recombinase polymerase amplification (RPA) followed by CRISPR/Cas12a (referred to as RPA-CRISPR/Cas12a) was developed and optimized for the determination of Plasmodium spp. parasites, particularly Plasmodium falciparum, using a fluorescence-based assay (FBDA), lateral flow test strips (LFTS), or naked eye observation (NEO). Then, the established platform was assessed with clinical malaria isolates. Under optimal conditions, the detection threshold was 1 copy/μL for the plasmid, and the limit of detection was 3.11-7.27 parasites/μL for dried blood spots. There was no cross-reactivity against blood-borne pathogens. For the accuracies of RPA-CRISPR/Cas12a, Plasmodium spp. and P. falciparum testing were 98.68 and 94.74%, respectively. The method was consistent with nested PCR results and superior to the qPCR results. RPA-CRISPR/Cas12a is a rapid, ultrasensitive, and reliable platform for malaria diagnosis. The platform requires no or minimal instrumentation for nucleic acid amplification reactions and can be read with the naked eye. Compared with similar diagnostic methods, this platform improves the reaction speed while reducing detection requirements. Therefore, this platform has the potential to become a true POCT for malaria parasites.
Collapse
Affiliation(s)
- Huagui Wei
- Department of Reproductive Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Jian Li
- School of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, People's Republic of China
| | - Yaqun Liu
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou 521041, People's Republic of China
| | - Weijia Cheng
- Department of Clinical Laboratory, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
| | - Huiying Huang
- Medical Laboratory of Shenzhen Luohu People's Hospital, Shenzhen 518005, People's Republic of China
| | - Xueyan Liang
- Laboratory Medical Center, Huizhou Municipal Central Hospital, Huizhou 516008, People's Republic of China
| | - Weiyi Huang
- Key Laboratory of Environmental Pollution and Health Risk Assessment, Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Liyun Lin
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou 521041, People's Republic of China
| | - Yuzhong Zheng
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou 521041, People's Republic of China
| | - Weizhong Chen
- Department of Medical Laboratory, Chaozhou People's Hospital Affiliated to Shantou University Medical College, Chaozhou 521011, People's Republic of China
| | - Chunfang Wang
- Department of Reproductive Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Wencheng Chen
- Guangxi Medical and Health Key Discipline Construction Project of the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Guidan Xu
- Department of Reproductive Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Wujun Wei
- Department of Reproductive Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Liying Chen
- Industrial College of Biomedicine and Health Industry, Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Yongmei Zeng
- Department of Medical Laboratory, Chaozhou People's Hospital Affiliated to Shantou University Medical College, Chaozhou 521011, People's Republic of China
| | - Zefang Lu
- Department of Medical Laboratory, Chaozhou People's Hospital Affiliated to Shantou University Medical College, Chaozhou 521011, People's Republic of China
| | - Shujuan Li
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou 521041, People's Republic of China
| | - Zongyun Lin
- Department of Reproductive Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Junli Wang
- Department of Reproductive Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
- Key Laboratory of Environmental Pollution and Health Risk Assessment, Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
- Reproductive Medicine, Guangxi Medical and Health Key Discipline Construction Project, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| | - Min Lin
- Department of Reproductive Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, People's Republic of China
| |
Collapse
|
7
|
Comparison of Rapid Diagnostic Test, Microscopy, and Polymerase Chain Reaction for the Detection of Plasmodium falciparum Malaria in a Low-Transmission Area, Jazan Region, Southwestern Saudi Arabia. Diagnostics (Basel) 2022; 12:diagnostics12061485. [PMID: 35741295 PMCID: PMC9222139 DOI: 10.3390/diagnostics12061485] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
This cross-sectional study aimed to assess the performances of a rapid diagnostic test (RDT)—the AllTest Malaria p.f./p.v., microscopy, and nested polymerase chain reaction (PCR) for diagnosing Plasmodium falciparum malaria in 400 febrile patients from a low-transmission region (Jazan) in southwestern Saudi Arabia. Diagnostic performance of all three methods was compared using microscopy and nested PCR as reference methods. Overall, 42 (10.5%), 48 (12.0%), and 57 (14.3%) samples were found positive by microscopy, RDT, and PCR, respectively. With PCR as reference method, the RDT showed higher sensitivity (79% vs. 71.9%), similar specificity (99.1% vs. 99.7%), and better NLR (0.20 vs. 0.27) and area under the curve (89.0% vs. 85.8%) than microscopy. The sensitivity of RDT and microscopy decreased as age increased, and false negatives were associated with low parasite density. In addition, the sensitivity of RDT and microscopy was higher in non-Saudi than in Saudi participants. Against microscopy, both RDT and PCR showed high sensitivity (83.3% vs. 97.6%), specificity (96.4% vs. 95.5%), and NPVs (98.0% vs. 99.7%), but reduced PPVs (72.9% vs. 71.9%), respectively. The results showed that the performance of the AllTest Malaria p.f./p.v RDT was better than that of microscopy in diagnosing P. falciparum malaria among febrile patients in the Jazan region when nested PCR was used as the reference. However, further studies are required to assess malaria diagnostic methods among asymptomatic individuals in the region.
Collapse
|