1
|
Sharma A, Azam M, Verma PK, Talwar V, Roy S, Veeraraghavan B, Singh R, Gaind R. Application of LAMP assay for detection of carbapenem-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii complex in ICU admitted sepsis patients: A rapid and cost-effective diagnostic tool. Diagn Microbiol Infect Dis 2024; 110:116398. [PMID: 38908041 DOI: 10.1016/j.diagmicrobio.2024.116398] [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: 04/04/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 06/24/2024]
Abstract
Carbapenem-resistant significant members of Acinetobacter calcoaceticus-Acinetobacter baumannii (CR-SM-ACB) complex have emerged as an important cause of sepsis, especially in ICUs. This study demonstrates the application of loop-mediated-isothermal-amplification (LAMP) assay for detection of CR-SM-ACB-complex from patients with sepsis. Whole-blood and culture-broths(CB) collected from patients with culture-positive sepsis were subjected to LAMP and compared with PCR, and RealAmp. Vitek-2 system and conventional PCR results were used as confirmatory references. The sensitivity and specificity of LAMP(97 % & 100 %) and RealAmp(100 % & 100 %) for detection of CR-SM-ACB-complex from CB were better than PCR(87 % & 100 %). Diagnostic accuracy of LAMP, RealAmp, and PCR for detection of SM-ACB-complex from CB was 98.5 %, 100 %, and 88.5 % respectively. Turnaround time of Culture, LAMP, PCR, and RealAmp was 28-53, 6-20, 9-23, and 6-20hours, respectively. LAMP is a simple, inexpensive tool that can be applied directly to positive CB and may be customized to detect emerging pathogens and locally-prevalent resistance genes and to optimize antimicrobial use.
Collapse
Affiliation(s)
- Amit Sharma
- Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India; University School of Medicine and Paramedical Health Sciences, Guru Gobind Singh Indraprastha University, New Delhi, Dwarka 110078, India
| | - Mudsser Azam
- ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi 110029, India
| | - P K Verma
- Department of Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | - Vandana Talwar
- Department of Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | - Subhasree Roy
- Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata 700010, India
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore 632004, India
| | - Ruchi Singh
- ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi 110029, India
| | - Rajni Gaind
- Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India.
| |
Collapse
|
2
|
Puri M, Kaur Brar H, Madan E, Srinivasan R, Rawat K, Gorthi SS, Kumari G, Sah R, Ojha SB, Panigrahi S, Dhangadamajhi G, Muthuswami R, Singh S, Madhubala R. Rapid diagnosis of Plasmodium falciparum malaria using a point-of-care loop-mediated isothermal amplification device. Front Cell Infect Microbiol 2022; 12:961832. [PMID: 36061865 PMCID: PMC9437306 DOI: 10.3389/fcimb.2022.961832] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
LAMP diagnosis of malaria is simple and cost-effective with acceptable sensitivity and specificity as compared to standard diagnostic modules such as microscopy, RDTs and nested PCR, and thus its deployment for onsite screening of malaria in resource-limited regions is under consideration. However, the requirement of an electricity-operated dry bath and bulky read-out unit is still a major concern. In an effort to simplify this limitation, we have developed a portable LAMP device and fluorescence readout unit which can be used in the rapid point-of-care diagnosis of malaria. We have developed a point-of-care diagnostic LAMP device that is easy to operate by a mobile application, and the results can be quantified with a fluorescent readout unit. The diagnostic performance of the device was evaluated in 90 P. falciparum-infected clinical isolates stored at 4°C for 6-7 years and 10 freshly collected isolates from healthy volunteers. The LOD and quantitative ability of LAMP in estimating parasitemia levels were revealed with laboratory-grown P. falciparum strain (3D7). The LAMP assay performed in our device was exclusive for P. falciparum detection with sensitivity and specificity determined to be 98.89% and 100%, respectively, in clinical isolates. The LOD was documented to be 1 parasite/µl at the cut-off ADC value of 20. Parasite density estimated from ADC values showed concordance with microscopically determined parasite density of the cultured P. falciparum 3D7 strain. The LAMP assay performed in our device provides a possible portable platform for its deployment in the point-of-care diagnosis of malaria. Further validation of the quantitative ability of the assay with freshly collected or properly stored clinical samples of known parasitemia is necessary for field applicability.
Collapse
Affiliation(s)
- Madhu Puri
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | | | - Evanka Madan
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Rajesh Srinivasan
- Department of Instrumentation and Applied Physics, Indian Institute of Science, Bengaluru, India
| | - Kapil Rawat
- Department of Instrumentation and Applied Physics, Indian Institute of Science, Bengaluru, India
| | - Sai Siva Gorthi
- Department of Instrumentation and Applied Physics, Indian Institute of Science, Bengaluru, India
| | - Geeta Kumari
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, India
| | - Raj Sah
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, India
| | - Sashi Bhusan Ojha
- Department of Biotechnology, Maharaja Sriram Chandra Bhanjadeo University, Baripada, India
| | - Subhendu Panigrahi
- Department of General Medicine, VSS Medical College and Hospital, Sambalpur, India
| | | | - Rohini Muthuswami
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Shailja Singh
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, India
- *Correspondence: Rentala Madhubala, ; Shailja Singh,
| | - Rentala Madhubala
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
- *Correspondence: Rentala Madhubala, ; Shailja Singh,
| |
Collapse
|
3
|
Oyegoke OO, Maharaj L, Akoniyon OP, Kwoji I, Roux AT, Adewumi TS, Maharaj R, Oyebola BT, Adeleke MA, Okpeku M. Malaria diagnostic methods with the elimination goal in view. Parasitol Res 2022; 121:1867-1885. [PMID: 35460369 PMCID: PMC9033523 DOI: 10.1007/s00436-022-07512-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/01/2022] [Indexed: 01/08/2023]
Abstract
Malaria control measures have been in use for years but have not completely curbed the spread of infection. Ultimately, global elimination is the goal. A major playmaker in the various approaches to reaching the goal is the issue of proper diagnosis. Various diagnostic techniques were adopted in different regions and geographical locations over the decades, and these have invariably produced diverse outcomes. In this review, we looked at the various approaches used in malaria diagnostics with a focus on methods favorably used during pre-elimination and elimination phases as well as in endemic regions. Microscopy, rapid diagnostic testing (RDT), loop-mediated isothermal amplification (LAMP), and polymerase chain reaction (PCR) are common methods applied depending on prevailing factors, each with its strengths and limitations. As the drive toward the elimination goal intensifies, the search for ideal, simple, fast, and reliable point-of-care diagnostic tools is needed more than ever before to be used in conjunction with a functional surveillance system supported by the ideal vaccine.
Collapse
Affiliation(s)
- Olukunle O Oyegoke
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Leah Maharaj
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Oluwasegun P Akoniyon
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Illiya Kwoji
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Alexandra T Roux
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Taiye S Adewumi
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Rajendra Maharaj
- Office of Malaria Research, Medical Research Council, Durban, South Africa
| | | | - Matthew A Adeleke
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Moses Okpeku
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa.
| |
Collapse
|
4
|
Mirahmadi H, Shahrakipour A, Mehravaran A, Rahmati-Balaghaleh M, Zarean M, Etemadi S, Shahraki M, Solgi R. Evaluation of Multiplex/Nested Polymerase Chain Reaction and Loop-Mediated Isothermal Amplification for Malaria Diagnosis in Southeastern Iran. Am J Trop Med Hyg 2022; 106:841-845. [PMID: 35100562 PMCID: PMC8922511 DOI: 10.4269/ajtmh.21-0970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/15/2021] [Indexed: 11/07/2022] Open
Abstract
Malaria is one of the most serious health problems in many countries, including Iran. Accurate diagnosis is important regardless of the elimination status of a country. A cross-sectional study was performed on 105 people who were suspected to be positive for malaria infection in Sistan and Baluchistan, Iran. Blood smears (thin and thick films) were stained with 10% Giemsa. DNA was extracted from the prepared thin and thick films for molecular methods. Multiplex/nested polymerase chain reaction (mn-PCR), loop-mediated isothermal amplification (LAMP), and light microscopy (LM) were compared with nested PCR (nPCR) as a gold standard. Of 105 subjects, 52 (49.5%), 58 (55.2%), 58 (55.2%), and 63 (60%) were positive for malaria by LM, nPCR, mn-PCR, and LAMP, respectively. The sensitivity, specificity, and kappa were 92.1%, 100%, and 0.9 for LAMP and 100%, 100%, and 1 for mn-PCR, respectively. Eight cases of coinfection (Plasmodium vivax and Plasmodium falciparum) that were not detected by LM method were diagnosed by mn-PCR and LAMP. In the present study, the high sensitivity and specificity of LAMP and mn-PCR indicate that these two tests are good alternatives to nPCR for malaria diagnosis.
Collapse
Affiliation(s)
- Hadi Mirahmadi
- Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;,Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Azam Shahrakipour
- Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;,Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ahmad Mehravaran
- Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;,Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mansour Rahmati-Balaghaleh
- Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;,Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehdi Zarean
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;,Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;,Address correspondence to Rahmat Solgi, Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran, E-mail: or Mehdi Zarean, Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, E-mail:
| | - Soodabeh Etemadi
- Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;,Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehdi Shahraki
- Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Rahmat Solgi
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran;,Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran,Address correspondence to Rahmat Solgi, Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran, E-mail: or Mehdi Zarean, Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, E-mail:
| |
Collapse
|
5
|
Choi G, Guan W. Sample-to-Answer Microfluidic Nucleic Acid Testing (NAT) on Lab-on-a-Disc for Malaria Detection at Point of Need. Methods Mol Biol 2022; 2393:297-313. [PMID: 34837186 PMCID: PMC9191616 DOI: 10.1007/978-1-0716-1803-5_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
One of the grand challenges for field-deployable NATs is related to the front end of the assays-nucleic acid extraction from raw samples. The ideal nucleic acid sample preparation should be simple, scalable, and easy-to-operate. In this chapter, we present a lab-on-a-disc NAT device for sample-to-answer malaria diagnosis. The parasite DNA sample preparation and subsequent real-time LAMP detection are seamlessly integrated on a disposable single microfluidic compact disc, driven by energy-efficient, non-centrifuge-based magnetic field interactions. Each disc contains four parallel testing units, which could be configured either as four identical tests or as four species-specific tests. When configured as species-specific tests, it could identify two of the most life-threatening malaria species (P. falciparum and P. vivax). The reagent disc with a 4-plex analyzer (discussed in Chapter 1 ) is capable of processing four samples simultaneously with 40 min turnaround time. It achieves a detection limit of ~0.5 parasites/μl for whole blood, sufficient for detecting asymptomatic parasite carriers. The assay is performed with an automated device described in Chapter 14 . The combination of sensitivity, specificity, cost, and scalable sample preparation suggests the real-time fluorescence LAMP device could be particularly useful for malaria screening in field settings.
Collapse
Affiliation(s)
- Gihoon Choi
- Department of Electrical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Weihua Guan
- Department of Electrical Engineering, Pennsylvania State University, University Park, PA, USA.
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, USA.
| |
Collapse
|
6
|
Brilhante-da-Silva N, do Nascimento Martinez L, de Oliveira Sousa RM, dos Santos Pereira S, Teles CBG. Innovations in Plasmodium spp . diagnosis on diverse detection platforms. 3 Biotech 2021; 11:505. [PMID: 34881167 DOI: 10.1007/s13205-021-03054-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022] Open
Abstract
In 2019, 229 million cases of malaria were recorded worldwide. For epidemiologic surveillance and proper treatment of persons infected with Plasmodium spp., rapid detection of infections by Plasmodium spp. is critical. Thus, Plasmodium spp. diagnosis is one of the indispensable measures for malaria control. Although microscopy is the gold standard for diagnosis, it has restrictions related mainly to the lack of qualified human resources, which is a problem in many regions. Thus, this review presents major innovations in diagnostic methods as alternatives to or complementary to microscopy. Detection platforms in lateral flow systems, electrochemical immunosensors, molecular biology and, more recently, those integrated with smartphones, are highlighted, among others. The advanced improvement of these tests aims to provide techniques that are sensitive and specific, but also quick, easy to handle and free from the laboratory environment. In this way, the tracking of malaria cases can become increasingly effective and contribute to controlling the disease.
Collapse
|
7
|
Barazorda KA, Salas CJ, Braga G, Ricopa L, Ampuero JS, Siles C, Sanchez JF, Montano S, Lizewski SE, Joya CA, Bishop DK, Valdivia HO. Validation study of Boil & Spin Malachite Green Loop Mediated Isothermal Amplification (B&S MG-LAMP) versus microscopy for malaria detection in the Peruvian Amazon. PLoS One 2021; 16:e0258722. [PMID: 34695122 PMCID: PMC8544869 DOI: 10.1371/journal.pone.0258722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/04/2021] [Indexed: 11/19/2022] Open
Abstract
Malaria elimination efforts in Peru have dramatically reduced the incidence of cases in the Amazon Basin. To achieve the elimination, the detection of asymptomatic and submicroscopic carriers becomes a priority. Therefore, efforts should focus on tests sensitive enough to detect low-density parasitemia, deployable to resource-limited areas and affordable for large screening purposes. In this study, we assessed the performance of the Malachite–Green LAMP (MG-LAMP) using heat-treated DNA extraction (Boil & Spin; B&S MG-LAMP) on 283 whole blood samples collected from 9 different sites in Loreto, Peru and compared its performance to expert and field microscopy. A real-time PCR assay was used to quantify the parasite density. In addition, we explored a modified version of the B&S MG-LAMP for detection of submicroscopic infection in 500 samples and compared the turnaround time and cost of the MG-LAMP with microscopy. Compared to expert microscopy, the genus B&S MG-LAMP had a sensitivity of 99.4% (95%CI: 96.9%– 100%) and specificity of 97.1% (95%CI: 91.9%– 99.4%). The P. vivax specific B&S MG-LAMP had a sensitivity of 99.4% (96.6%– 100%) and specificity of 99.2% (95.5%– 100%) and the P. falciparum assay had a sensitivity of 100% (95%CI: 78.2%– 100%) and specificity of 99.3% (95%CI: 97.3%– 99.8%). The modified genus B&S MG-LAMP assay detected eight submicroscopic malaria cases (1.6%) which the species-specific assays did not identify. The turnaround time of B&S MG-LAMP was faster than expert microscopy with as many as 60 samples being processed per day by field technicians with limited training and utilizing a simple heat-block. The modified B&S MG-LAMP offers a simple and sensitive molecular test of choice for the detection of submicroscopic infections that can be used for mass screening in resources limited facilities in endemic settings nearing elimination and where a deployable test is required.
Collapse
Affiliation(s)
| | - Carola J. Salas
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Greys Braga
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Leonila Ricopa
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Julia S. Ampuero
- Department of Virology and Emerging infections, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Crystyan Siles
- Department of Virology and Emerging infections, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Juan F. Sanchez
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Silvia Montano
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Stephen E. Lizewski
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Christie A. Joya
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Danett K. Bishop
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Hugo O. Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
- * E-mail:
| |
Collapse
|
8
|
Colbert AJ, Co K, Lima-Cooper G, Lee DH, Clayton KN, Wereley ST, John CC, Linnes JC, Kinzer-Ursem TL. Towards the use of a smartphone imaging-based tool for point-of-care detection of asymptomatic low-density malaria parasitaemia. Malar J 2021; 20:380. [PMID: 34563189 PMCID: PMC8466697 DOI: 10.1186/s12936-021-03894-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Globally, there are over 200 million cases of malaria annually and over 400,000 deaths. Early and accurate detection of low-density parasitaemia and asymptomatic individuals is key to achieving the World Health Organization (WHO) 2030 sustainable development goals of reducing malaria-related deaths by 90% and eradication in 35 countries. Current rapid diagnostic tests are neither sensitive nor specific enough to detect the low parasite concentrations in the blood of asymptomatic individuals. METHODS Here, an imaging-based sensing technique, particle diffusometry (PD), is combined with loop mediated isothermal amplification (LAMP) on a smartphone-enabled device to detect low levels of parasitaemia often associated with asymptomatic malaria. After amplification, PD quantifies the Brownian motion of fluorescent nanoparticles in the solution during a 30 s video taken on the phone. The resulting diffusion coefficient is used to detect the presence of Plasmodium DNA amplicons. The coefficients of known negative samples are compared to positive samples using a one-way ANOVA post-hoc Dunnett's test for confirmation of amplification. RESULTS As few as 3 parasite/µL of blood was detectable in 45 min without DNA extraction. Plasmodium falciparum parasites were detected from asymptomatic individuals' whole blood samples with 89% sensitivity and 100% specificity when compared to quantitative polymerase chain reaction (qPCR). CONCLUSIONS PD-LAMP is of value for the detection of low density parasitaemia especially in areas where trained personnel may be scarce. The demonstration of this smartphone biosensor paired with the sensitivity of LAMP provides a proof of concept to achieve widespread asymptomatic malaria testing at the point of care.
Collapse
Affiliation(s)
- Ashlee J Colbert
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Katrina Co
- Indiana University School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Giselle Lima-Cooper
- Indiana University School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Dong Hoon Lee
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | | | - Steven T Wereley
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Chandy C John
- Indiana University School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Jacqueline C Linnes
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
| | - Tamara L Kinzer-Ursem
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
| |
Collapse
|
9
|
Keaney D, Whelan S, Finn K, Lucey B. Misdiagnosis of SARS-CoV-2: A Critical Review of the Influence of Sampling and Clinical Detection Methods. Med Sci (Basel) 2021; 9:36. [PMID: 34070530 PMCID: PMC8162574 DOI: 10.3390/medsci9020036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 infection has generated the biggest pandemic since the influenza outbreak of 1918-1919. One clear difference between these pandemics has been the ability to test for the presence of the virus or for evidence of infection. This review examined the performance characteristics of sample types via PCR detection of the virus, of antibody testing, of rapid viral antigen detection kits and computerised tomography (CT) scanning. It was found that combined detection approaches, such as the incorporation of CT scans, may reduce the levels of false negatives obtained by PCR detection in both symptomatic and asymptomatic patients, while sputum and oral throat washing sample types should take precedence over swabbing when available. Rt-PCR assays for detection of the virus remain the gold-standard method for SARS-CoV-2 diagnosis and can be used effectively on pooled samples for widespread screening. The novel Oxford antibody assay was found to have the highest sensitivity and specificity of four currently available commercial antibody kits but should only be used during a specific timeframe post-symptom onset. Further research into transmission modes between symptomatic and asymptomatic patients is needed. Analysis of the performance characteristics of different sampling and detection methods for SARS-CoV-2 showed that timing of sampling and testing methods used can greatly influence the rate of false-positive and false-negative test results, thereby influencing viral spread.
Collapse
Affiliation(s)
- Daniel Keaney
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland; (D.K.); (S.W.); (B.L.)
| | - Shane Whelan
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland; (D.K.); (S.W.); (B.L.)
| | - Karen Finn
- Department of Biopharmaceutical and Medical Science, Galway-Mayo Institute of Technology, Old Dublin Road, H91 DCH9 Galway, Ireland
| | - Brigid Lucey
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland; (D.K.); (S.W.); (B.L.)
| |
Collapse
|
10
|
Performance and Application of Commercially Available Loop-Mediated Isothermal Amplification (LAMP) Kits in Malaria Endemic and Non-Endemic Settings. Diagnostics (Basel) 2021; 11:diagnostics11020336. [PMID: 33670618 PMCID: PMC7922894 DOI: 10.3390/diagnostics11020336] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 01/04/2023] Open
Abstract
Loop-mediated isothermal amplification (LAMP) is a sensitive molecular tool suitable for use as a near point-of-care test for the diagnosis of malaria. Recent meta-analyses have detailed high sensitivity and specificity of malaria LAMP when compared to microscopy, rapid diagnostic tests, and polymerase chain reaction in both endemic and non-endemic settings. Despite this, the use of malaria LAMP has primarily been limited to research settings to date. In this review, we aim to assess to what extent commercially available malaria LAMP kits have been applied in different settings, and to identify possible obstacles that may have hindered their use from being adopted further. In order to address this, we conducted a literature search in PubMed.gov using the search terms (((LAMP) OR (Loop-mediated isothermal amplification)) AND ((Malaria) OR (Plasmodium))). Focusing primarily on studies employing one of the commercially available kits, we then selected three key areas of LAMP application for further review: the performance and application of LAMP in malaria endemic settings including low transmission areas; LAMP for malaria screening during pregnancy; and malaria LAMP in returning travelers in non-endemic settings.
Collapse
|
11
|
Picot S, Cucherat M, Bienvenu AL. Systematic review and meta-analysis of diagnostic accuracy of loop-mediated isothermal amplification (LAMP) methods compared with microscopy, polymerase chain reaction and rapid diagnostic tests for malaria diagnosis. Int J Infect Dis 2020; 98:408-419. [PMID: 32659450 DOI: 10.1016/j.ijid.2020.07.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Diagnosis is a challenging issue for eliminating malaria. Loop-mediated isothermal amplification (LAMP) could be an alternative to conventional methods. This study aimed to evaluate the diagnostic accuracy of LAMP for malaria compared with microscopy, polymerase chain reaction (PCR) and rapid diagnostic tests (RDTs). METHODS AND DESIGN MEDLINE, Web of Science and Scopus were searched from inception to 1 July 2019. Prospective and retrospective, randomised and non-randomised, mono-center and multi-center studies, including symptomatic or asymptomatic patients, that reported one LAMP method and one comparator (microscopy, RDT or PCR) were included. PROSPERO registration number: CRD42017075186. RESULTS Sixty-six studies published between 2006 and 2019 were included, leading to the analysis of 30,641 LAMP tests. The pooled sensitivity of LAMP remained between 96% and 98%, whichever the comparator. The pooled specificity of LAMP was around 95%, but was a little higher if the best PCR studies were considered. The AUC was found to be >0.98, whichever the subgroup of studies was considered. Diagnostic odds ratio (DOR) was found to be around 1000 for all subgroups, except for Plasmodium vivax. CONCLUSION This meta-analysis confirmed that the LAMP method is robust for diagnosing malaria, both in symptomatic and asymptomatic people. Thus, the impact of LAMP for controlling malaria is expected to be important.
Collapse
Affiliation(s)
- Stephane Picot
- Malaria Research Unit, SMITh, ICBMS UMR 5246 CNRS-INSA-CPE-Université de Lyon, Campus Lyon-Tech La Doua, 69622 Villeurbanne Cedex, France; Institut de Parasitologie et Mycologie Médicale, Hôpital de La Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Michel Cucherat
- Service de Pharmacotoxicologie, Hospices Civils de Lyon, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR5558, Université Lyon 1, Lyon, France
| | - Anne-Lise Bienvenu
- Malaria Research Unit, SMITh, ICBMS UMR 5246 CNRS-INSA-CPE-Université de Lyon, Campus Lyon-Tech La Doua, 69622 Villeurbanne Cedex, France; Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, France; Service d'Hématologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, France.
| |
Collapse
|
12
|
Aninagyei E, Smith-Graham S, Boye A, Egyir-Yawson A, Acheampong DO. Evaluating 18s-rRNA LAMP and selective whole genome amplification (sWGA) assay in detecting asymptomatic Plasmodium falciparum infections in blood donors. Malar J 2019; 18:214. [PMID: 31234871 PMCID: PMC6591871 DOI: 10.1186/s12936-019-2850-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/19/2019] [Indexed: 11/18/2022] Open
Abstract
Background Undesirable consequences of donor Plasmodium falciparum parasitaemia on stored donor blood have been reported. Therefore, it is imperative that all prospective blood donors are screened for P. falciparum infections using sensitive techniques. In this study, the sensitivities of microscopy, rapid diagnostic test (RDT), loop-mediated isothermal amplification (LAMP) assay and selective whole genome amplification (sWGA) technique in detecting P. falciparum infections in blood donors was assessed. Methods Randomly selected blood donors from 5 districts in Greater Accra Region of Ghana were screened for asymptomatic P. falciparum infections. Each donor sample was screened with SD Bioline RDT kit for P. falciparum histidine rich protein 2 and Plasmodium lactate dehydrogenase antigens, sWGA and 18s-rRNA LAMP. Crude DNA LAMP (crDNA-LAMP) was compared to purified DNA LAMP (pDNA-LAMP). Results A total of 771 blood donors were screened. The respective overall prevalence of P. falciparum in Ghana by microscopy, RDT, crDNA-LAMP, pDNA-LAMP and sWGA was 7.4%, 11.8%, 16.9%, 17.5% and 18.0%. Using sWGA as the reference test, the sensitivities of microscopy, RDT, crDNA-LAMP and pDNA-LAMP were 41.0% (95% CI 32.7–49.7), 65.5% (95% CI 56.9–73.3), 82.6% (95% CI 75.8–88.3) and 95.7% (95% CI 90.1–98.4), respectively. There was near perfect agreement between LAMP and sWGA (sWGA vs. crDNA-LAMP, κ = 0.87; sWGA vs. pDNA-LAMP, κ = 0.96), while crDNA-LAMP and pDNA-LAMP agreed perfectly (κ = 0.91). Goodness of fit test indicated non-significant difference between the performance of LAMP and sWGA (crDNA-LAMP vs. sWGA: x2 = 0.71, p = 0.399 and pDNA-LAMP vs. sWGA: x2 = 0.14, p = 0.707). Finally, compared to sWGA, the performance of LAMP did not differ in detecting sub-microscopic parasitaemia (sWGA vs. crDNA-LAMP: x2 = 1.12, p = 0.290 and sWGA vs. pDNA-LAMP: x2 = 0.22, p = 0.638). Conclusions LAMP assay agreed near perfectly with sWGA with non-significant differences in their ability to detect asymptomatic P. falciparum parasitaemia in blood donors. Therefore, it is recommended that LAMP based assays are employed to detect P. falciparum infections in blood donors due to its high sensitivity, simplicity, cost-effectiveness and user-friendliness.
Collapse
Affiliation(s)
- Enoch Aninagyei
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana. .,Wellcome Sanger Institute, Hinxton, CB10 1SA, UK.
| | | | - Alex Boye
- Department of Medical Laboratory Science, University of Cape Coast, Cape Coast, Ghana
| | - Alexander Egyir-Yawson
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Desmond Omane Acheampong
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
| |
Collapse
|
13
|
Loop-mediated isothermal amplification (LAMP) approach for detection of heat-resistant Talaromyces flavus species. Sci Rep 2019; 9:5846. [PMID: 30971732 PMCID: PMC6458134 DOI: 10.1038/s41598-019-42275-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/27/2019] [Indexed: 11/29/2022] Open
Abstract
Talaromyces flavus is a soilborne fungus that can contaminate fruits. It constitutes serious influence on heat-processed food spoilage, as T. flavus belongs to the heat-resistant fungi group, which are able to survive the pasteurization process. Moreover T. flavus has been reported to be capable of mycotoxigenicity, therefore they have a serious threat to human health. To maintain the safety of food production, sensitive method for T. flavus detection was developed. The loop mediated amplification, abbreviated LAMP, reactions were designed as specific for detection of DNA replication licensing factor gene of T. flavus. The specificity of assay was confirmed by use of 5 T. flavus strains and 35 other fungal isolates. The achieved limit of detection was 1fg of T. flavus genomic DNA and 64 ascospores in 1 g of strawberry fruits or soil samples.
Collapse
|
14
|
Quah YW, Waltmann A, Karl S, White MT, Vahi V, Darcy A, Pitakaka F, Whittaker M, Tisch DJ, Barry A, Barnadas C, Kazura J, Mueller I. Molecular epidemiology of residual Plasmodium vivax transmission in a paediatric cohort in Solomon Islands. Malar J 2019; 18:106. [PMID: 30922304 PMCID: PMC6437916 DOI: 10.1186/s12936-019-2727-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/14/2019] [Indexed: 01/03/2023] Open
Abstract
Background Following the scale-up of intervention efforts, malaria burden has decreased dramatically in Solomon Islands (SI). Submicroscopic and asymptomatic Plasmodium vivax infections are now the major challenge for malaria elimination in this country. Since children have higher risk of contracting malaria, this study investigated the dynamics of Plasmodium spp. infections among children including the associated risk factors of residual P. vivax burden. Methods An observational cohort study was conducted among 860 children aged 0.5–12 years in Ngella (Central Islands Province, SI). Children were monitored by active and passive surveillances for Plasmodium spp. infections and illness. Parasites were detected by quantitative real-time PCR (qPCR) and genotyped. Comprehensive statistical analyses of P. vivax infection prevalence, molecular force of blood stage infection (molFOB) and infection density were conducted. Results Plasmodium vivax infections were common (overall prevalence: 11.9%), whereas Plasmodium falciparum infections were rare (0.3%) but persistent. Although children acquire an average of 1.1 genetically distinct P. vivax blood-stage infections per year, there was significant geographic heterogeneity in the risks of P. vivax infections across Ngella (prevalence: 1.2–47.4%, p < 0.01; molFOB: 0.05–4.6/year, p < 0.01). Malaria incidence was low (IR: 0.05 episodes/year-at-risk). Age and measures of high exposure were the key risk factors for P. vivax infections and disease. Malaria incidence and infection density decreased with age, indicating significant acquisition of immunity. G6PD deficient children (10.8%) that did not receive primaquine treatment had a significantly higher prevalence (aOR: 1.77, p = 0.01) and increased risk of acquiring new bloodstage infections (molFOB aIRR: 1.51, p = 0.03), underscoring the importance of anti-relapse treatment. Conclusion Residual malaria transmission in Ngella exhibits strong heterogeneity and is characterized by a high proportion of submicroscopic and asymptomatic P. vivax infections, alongside sporadic P. falciparum infections. Implementing an appropriate primaquine treatment policy to prevent P. vivax relapses and specific targeting of control interventions to high risk areas will be required to accelerate ongoing control and elimination activities. Electronic supplementary material The online version of this article (10.1186/s12936-019-2727-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yi Wan Quah
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Andreea Waltmann
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Stephan Karl
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Michael T White
- Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Ventis Vahi
- National Health Training & Research Institute, Ministry of Health, Honiara, Solomon Islands
| | - Andrew Darcy
- National Health Training & Research Institute, Ministry of Health, Honiara, Solomon Islands
| | - Freda Pitakaka
- National Health Training & Research Institute, Ministry of Health, Honiara, Solomon Islands
| | - Maxine Whittaker
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | | | - Alyssa Barry
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Celine Barnadas
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - James Kazura
- Case Western Reserve University, Cleveland, OH, USA
| | - Ivo Mueller
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia. .,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia. .,Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.
| |
Collapse
|
15
|
Cheaveau J, Nguyen H, Chow B, Marasinghe D, Mohon AN, Yuan H, Viana G, van Schalkwyk D, Church D, Chan W, Pillai DR. Clinical Validation of a Commercial LAMP Test for Ruling out Malaria in Returning Travelers: A Prospective Diagnostic Trial. Open Forum Infect Dis 2018; 5:ofy260. [PMID: 30465012 PMCID: PMC6239078 DOI: 10.1093/ofid/ofy260] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/08/2018] [Indexed: 12/21/2022] Open
Abstract
The mainstay of malaria diagnosis relies on rapid diagnostic tests (RDTs) and microscopy, both of which lack analytical sensitivity. This leads to repeat testing to rule out malaria. A prospective diagnostic trial of the Meridian illumigene Malaria assay (loop-mediated isothermal amplification [LAMP]) was conducted comparing it with reference microscopy and RDTs (BinaxNOW Malaria) in returning travelers between June 2017 and January 2018. Returning travelers with signs and symptoms of malaria were enrolled in the study. RDTs, microscopy, and LAMP assays were performed simultaneously. A total of 298 patients (50.7% male; mean age, 32.5 years) were enrolled, most visiting friends and relatives (43.3%), presenting with fever (88.9%), not taking prophylaxis (82.9%), and treated as outpatients (84.1%). In the prospective arm (n = 348), LAMP had a sensitivity of 98.1% (95% confidence interval [CI], 90.0%–100%) and a specificity of 97.6% (95% CI, 95.2%–99.1%) vs microscopy. After discrepant resolution with real-time polymerase chain reaction, LAMP had a sensitivity of 100% (95% CI, 93.7%–100%) and a specificity of 100% (95% CI, 98.7%–100%) vs microscopy. After discrepant resolution, RDTs had a sensitivity of 83.3% (95% CI, 58.6%–96.4%) and a specificity of 96.2% (95% CI, 93.2%–98.1%) vs microscopy. When including retrospective specimens (n = 377), LAMP had a sensitivity of 98.8% (95% CI, 93.2%–100%) and a specificity of 97.6% (95% CI, 95.2%–99.1%) vs microscopy, and after discrepant resolution of this set, LAMP had a sensitivity of 100% (95% CI, 95.8%–100%) and a specificity of 100% (95% CI, 98.7%–100%). A cost-benefit analysis of reagents and labor suggests savings of up to USD$13 per specimen using a novel algorithm with LAMP screening.
Collapse
Affiliation(s)
- James Cheaveau
- Clinical Section of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada.,Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta, Canada
| | - Hong Nguyen
- Clinical Section of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada
| | - Barbara Chow
- Clinical Section of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada
| | - Dewdunee Marasinghe
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Abu Naser Mohon
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta, Canada.,Laboratório de Pesquisas em Malária, Instituto Evandro Chagas, Levilândia Ananindeua, Pará, Brasil
| | - Hong Yuan
- ProvLab Alberta, Edmonton, Alberta, Canada
| | - Gisele Viana
- Laboratório de Pesquisas em Malária, Instituto Evandro Chagas, Levilândia Ananindeua, Pará, Brasil
| | - Donelly van Schalkwyk
- Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Deirdre Church
- Clinical Section of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada.,Department Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Wilson Chan
- Clinical Section of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada.,Department Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Dylan R Pillai
- Clinical Section of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada.,Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta, Canada.,Department Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
16
|
Sattabongkot J, Suansomjit C, Nguitragool W, Sirichaisinthop J, Warit S, Tiensuwan M, Buates S. Prevalence of asymptomatic Plasmodium infections with sub-microscopic parasite densities in the northwestern border of Thailand: a potential threat to malaria elimination. Malar J 2018; 17:329. [PMID: 30208895 PMCID: PMC6134695 DOI: 10.1186/s12936-018-2476-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/04/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Asymptomatic infections with sub-microscopic Plasmodium serve as a silent reservoir of disease, critical to sustaining a low level of remanent malaria in the population. These infections must be effectively identified and targeted for elimination. The sensitivity of light microscopy, the traditional method used for diagnosing Plasmodium infections, is frequently insufficient for detecting asymptomatic infections due to the low density of parasitaemia. The objective of this study was to explore the current prevalence of asymptomatic sub-microscopic Plasmodium carriages to evaluate the parasite reservoir amongst residents from 7 hamlets in Tak Province in northwestern Thailand using a highly sensitive molecular method. METHODS Malaria infection was screened in a real-world setting from 3650 finger-prick blood specimens collected in a mass cross-sectional survey using light microscopy and loop-mediated isothermal amplification (LAMP). LAMP results were later confirmed in a laboratory setting in Bangkok using nested PCR, restriction enzyme digestion and DNA sequencing. The association of malaria infection with demographic factors was explored. RESULTS Parasite prevalence was 0.27% (10/3650) as determined by microscopy. Sub-microscopic infection prevalence was 2.33% (85/3650) by LAMP. Of these, 30.6% (26/85) were infected with Plasmodium falciparum, 52.9% (45/85) with Plasmodium vivax, 2.4% (2/85) with Plasmodium malariae, 4.7% (4/85) with mixed P. falciparum and P. vivax, and 9.4% (8/85) had parasite densities too low for species identification. Asymptomatic carriages (T < 37.5 °C) accounted for 95% (76/80) of all sub-microscopic cases with the highest prevalence occurring in the subjects 31-45 years of age (p ≤ 0.035). Participants working on plantations or as merchants had an increased infection risk. Evaluation by microscopy identified 10.53% (10/95) of all Plasmodium infected participants. CONCLUSION Participants carrying asymptomatic Plasmodium infections with sub-microscopic parasite densities are considerable in this area. These findings provide the true disease burden and risk factors in this region. This information helps to direct policy makers towards better schemes and delivery of targeted interventions. Moreover, this is the first study to use LAMP in mass screening for sub-clinical and sub-microscopic infections in a field setting in Thailand. LAMP proves to be a sensitive and field-deployable assay suitable for national malaria control screening campaigns.
Collapse
Affiliation(s)
- Jetsumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chayanut Suansomjit
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Wang Nguitragool
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Saradee Warit
- Tuberculosis Research Laboratory, Medical Molecular Biology Research Unit, BIOTEC, National Science and Technology Development Agency, Thailand Science Park, Pathum Thani, Thailand
| | - Montip Tiensuwan
- Department of Mathematics, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Sureemas Buates
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
17
|
Tambo M, Auala JR, Sturrock HJ, Kleinschmidt I, Bock R, Smith JL, Gosling R, Mumbengegwi DR. Evaluation of loop-mediated isothermal amplification as a surveillance tool for malaria in reactive case detection moving towards elimination. Malar J 2018; 17:255. [PMID: 29986717 PMCID: PMC6038281 DOI: 10.1186/s12936-018-2399-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/25/2018] [Indexed: 11/11/2022] Open
Abstract
Background As malaria transmission decreases, the proportion of infections that are asymptomatic at any given time increases. This poses a challenge for diagnosis as routinely used rapid diagnostic tests (RDTs) miss asymptomatic malaria cases with low parasite densities due to poor sensitivity. Yet, asymptomatic infections can contribute to onward transmission of malaria and therefore act as infectious reservoirs and perpetuate malaria transmission. This study compared the performance of RDTs to loop-mediated isothermal amplification (LAMP) in the diagnosis of malaria during reactive active case detection surveillance. Methods All reported malaria cases in the Engela Health District of Namibia were traced back to their place of residence and persons living within the four closest neighbouring houses to the index case (neighbourhood) were tested for malaria infection with RDTs and dried blood spots (DBS) were collected. LAMP and nested PCR (nPCR) were carried out on all RDTs and DBS. The same procedure was followed in randomly selected control neighbourhoods. Results Some 3151 individuals were tested by RDT, LAMP and nPCR. Sensitivity of RDTs and LAMP were 9.30 and 95.50%, respectively, and specificities were 99.27 and 99.92%, respectively, compared to nPCR. LAMP carried out on collected RDTs showed a sensitivity and specificity of 95.35 and 99.85% compared to nPCR carried out on DBS. There were 2 RDT samples that were negative by LAMP but the corresponding DBS samples were positive by PCR. Conclusion The study showed that LAMP had the equivalent performance as nPCR for the identification of Plasmodium falciparum infection. Given its relative simplicity to implement over more complex and time-consuming methods, such as PCR, LAMP is particularly useful in elimination settings where high sensitivity and ease of operation are important.
Collapse
Affiliation(s)
- Munyaradzi Tambo
- Multidisciplinary Research Center, University of Namibia, Windhoek, Namibia
| | - Joyce R Auala
- Multidisciplinary Research Center, University of Namibia, Windhoek, Namibia
| | - Hugh J Sturrock
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Immo Kleinschmidt
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ronnie Bock
- Department of Biological Sciences, University of Namibia, Windhoek, Namibia
| | - Jennifer L Smith
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Roland Gosling
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Davis R Mumbengegwi
- Multidisciplinary Research Center, University of Namibia, Windhoek, Namibia.
| |
Collapse
|
18
|
Qin Y, Puthiyakunnon S, Zhang Y, Wu X, Boddu S, Luo B, Fan H. Rapid and Specific Detection of Escherichia coli O157:H7 in Ground Beef Using Immunomagnetic Separation Combined with Loop-Mediated Isothermal Amplification. POL J FOOD NUTR SCI 2018. [DOI: 10.1515/pjfns-2017-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
19
|
Mallepaddi PC, Lai MY, Podha S, Ooi CH, Liew JWK, Polavarapu R, Lau YL. Development of Loop-Mediated Isothermal Amplification-Based Lateral Flow Device Method for the Detection of Malaria. Am J Trop Med Hyg 2018; 99:704-708. [PMID: 29943720 DOI: 10.4269/ajtmh.18-0177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The present study aims to develop a method for rapid diagnosis of malaria using loop-mediated isothermal amplification (LAMP) combined with a lateral flow device (LFD). By adding the biotin-labeled and fluorescein amidite-labeled loop primers to the LAMP reaction solution, the end product can be visualized on a LFD. The entire procedure takes approximately 42 minutes to complete, LAMP assay exhibited high sensitivity, as the detection limit was 0.01 pg/μL for all five Plasmodium species. It was demonstrated that all Plasmodium knowlesi (N = 90) and Plasmodium vivax (N = 56) were positively amplified by LAMP-LFD assay, whereas healthy donor samples (N = 8) were negative. However, not all mixed infections were positive, and other infected nonmalaria samples were negative. Loop-mediated isothermal amplification-LFD represents a robust approach with potential suitability for use in resource-constrained laboratories. We believe that LAMP-LFD has a potential to be developed as point-of-care diagnostic tool in future.
Collapse
Affiliation(s)
- Prudhvi Chand Mallepaddi
- Department of Biotechnology, Acharya Nagarjuna University, Guntur, India.,Genomix Molecular Diagnostics Pvt. Ltd., Hyderabad, India
| | - Meng-Yee Lai
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sudhakar Podha
- Department of Biotechnology, Acharya Nagarjuna University, Guntur, India
| | - Choo-Huck Ooi
- Sarawak State Health Department, Jalan Diplomatik, Kuching, Malaysia
| | - Jonathan Wee-Kent Liew
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rathnagiri Polavarapu
- Department of Biotechnology, Acharya Nagarjuna University, Guntur, India.,Genomix Molecular Diagnostics Pvt. Ltd., Hyderabad, India
| | - Yee-Ling Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
20
|
Choi G, Prince T, Miao J, Cui L, Guan W. Sample-to-answer palm-sized nucleic acid testing device towards low-cost malaria mass screening. Biosens Bioelectron 2018; 115:83-90. [PMID: 29803865 DOI: 10.1016/j.bios.2018.05.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/29/2018] [Accepted: 05/10/2018] [Indexed: 12/22/2022]
Abstract
The effectiveness of malaria screening and treatment highly depends on the low-cost access to the highly sensitive and specific malaria test. We report a real-time fluorescence nucleic acid testing device for malaria field detection with automated and scalable sample preparation capability. The device consists a compact analyzer and a disposable microfluidic reagent compact disc. The parasite DNA sample preparation and subsequent real-time LAMP detection were seamlessly integrated on a single microfluidic compact disc, driven by energy efficient non-centrifuge based magnetic field interactions. Each disc contains four parallel testing units which could be configured either as four identical tests or as four species-specific tests. When configured as species-specific tests, it could identify two of the most life-threatening malaria species (P. falciparum and P. vivax). The NAT device is capable of processing four samples simultaneously within 50 min turnaround time. It achieves a detection limit of ~0.5 parasites/µl for whole blood, sufficient for detecting asymptomatic parasite carriers. The combination of the sensitivity, specificity, cost, and scalable sample preparation suggests the real-time fluorescence LAMP device could be particularly useful for malaria screening in the field settings.
Collapse
Affiliation(s)
- Gihoon Choi
- Department of Electrical Engineering, Pennsylvania State University, University Park 16802, USA
| | - Theodore Prince
- Department of Electrical Engineering, Pennsylvania State University, University Park 16802, USA
| | - Jun Miao
- Department of Entomology, Pennsylvania State University, University Park 16802, USA
| | - Liwang Cui
- Department of Entomology, Pennsylvania State University, University Park 16802, USA
| | - Weihua Guan
- Department of Electrical Engineering, Pennsylvania State University, University Park 16802, USA; Department of Biomedical Engineering, Pennsylvania State University, University Park 16802, USA.
| |
Collapse
|
21
|
Morrison J, Watts G, Hobbs G, Dawnay N. Field-based detection of biological samples for forensic analysis: Established techniques, novel tools, and future innovations. Forensic Sci Int 2018. [DOI: 10.1016/j.forsciint.2018.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
22
|
Kaur H, Sehgal R, Bansal D, Sultan AA, Bhalla A, Singhi SC. Development of Visually Improved Loop Mediated Isothermal Amplification for the Diagnosis of Plasmodium vivax Malaria in a Tertiary Hospital in Chandigarh, North India. Am J Trop Med Hyg 2018; 98:1374-1381. [PMID: 29557335 DOI: 10.4269/ajtmh.17-0857] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
More than 80% of the global burden of the Plasmodium vivax is contributed by mainly three countries (India, Indonesia, and Pakistan). Reports from last decades have highlighted the occurrence of severe P. vivax malaria which was earlier considered to be benign. The recent trends of increasing P. vivax-associated morbidity and mortality emphasizes the need for early and accurate diagnosis of P. vivax malaria for the timely management of patients. Microscopy is considered a gold standard but needs experienced laboratory technologists. Over the last few years, Polymerase chain reaction (PCR) is being used as a highly sensitive and specific test but it requires expensive equipment which limits its use in the field. Therefore, in the present study, utility of visually improved loop-mediated isothermal amplification (LAMP) for the detection of P. vivax was evaluated targeting 18SrRNA gene in 145 microscopically confirmed P. vivax and 20 P. vivax negative patients. Sensitivity and specificity of LAMP was assessed with respect to microscopy and multiplex nested PCR (nPCR). Results of the LAMP assay was also correlated with rapid diagnostic test, multiplex nPCR and real-time PCR results. Overall, sensitivity and specificity of P. vivax-specific LAMP compared with microscopy were found to be 100% and 85%, respectively. Furthermore, detection limit for LAMP was found to be 0.8 copies/μL and it was also able to detect three complicated cases of P. vivax which were missed by microscopy. This study showed a LAMP assay to be a rapid and very sensitive method for the early diagnosis of both complicated and uncomplicated P. vivax malaria.
Collapse
Affiliation(s)
- Hargobinder Kaur
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Sehgal
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Ashish Bhalla
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunit C Singhi
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
23
|
Abbasian F, Ghafar-Zadeh E, Magierowski S. Microbiological Sensing Technologies: A Review. Bioengineering (Basel) 2018; 5:E20. [PMID: 29498670 PMCID: PMC5874886 DOI: 10.3390/bioengineering5010020] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/23/2018] [Accepted: 02/23/2018] [Indexed: 12/13/2022] Open
Abstract
Microorganisms have a significant influence on human activities and health, and consequently, there is high demand to develop automated, sensitive, and rapid methods for their detection. These methods might be applicable for clinical, industrial, and environmental applications. Although different techniques have been suggested and employed for the detection of microorganisms, and the majority of these methods are not cost effective and suffer from low sensitivity and low specificity, especially in mixed samples. This paper presents a comprehensive review of microbiological techniques and associated challenges for bioengineering researchers with an engineering background. Also, this paper reports on recent technological advances and their future prospects for a variety of microbiological applications.
Collapse
Affiliation(s)
- Firouz Abbasian
- Biologically Inspired Sensors and Actuators Laboratory, Department of EECS, Lassonde School of Engineering, York University, Toronto, ON M3J 1P3, Canada.
| | - Ebrahim Ghafar-Zadeh
- Biologically Inspired Sensors and Actuators Laboratory, Department of EECS, Lassonde School of Engineering, York University, Toronto, ON M3J 1P3, Canada.
| | - Sebastian Magierowski
- Biologically Inspired Sensors and Actuators Laboratory, Department of EECS, Lassonde School of Engineering, York University, Toronto, ON M3J 1P3, Canada.
| |
Collapse
|
24
|
Chen HW, Ching WM. Evaluation of the stability of lyophilized loop-mediated isothermal amplification reagents for the detection of Coxiella burnetii. Heliyon 2017; 3:e00415. [PMID: 29057336 PMCID: PMC5639046 DOI: 10.1016/j.heliyon.2017.e00415] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/15/2017] [Accepted: 09/18/2017] [Indexed: 11/24/2022] Open
Abstract
Coxiella burnetii, the causative pathogen for Q fever, is an obligate intracellular bacterium and designated as a biosafety level 3 agent. Detection and quantification of the bacteria with conventional culturing methods is time-consuming and poses significant health risks. Polymerase chain reaction (PCR)-based assays have been developed for detecting C. burnetii and could provide rapid diagnosis. However, they require specialized equipment, including a cold chain for PCR reagents that maintains their stability during storage and transport. These requirements limit the advantage of PCR-based methods, especially in resource-limited areas. Previously, we had developed a lyophilized loop-mediated isothermal amplification (LAMP) assay to detect the presence of C. burnetii. To simplify and improve this assay, the reagents for the LAMP assay and the detecting reagent, SYBR green, were lyophilized together. The stability of the lyophilized reagents was evaluated by measuring changes in detection limit for plasmid DNA encoding a C. burnetii gene upon storage at 4 °C, 25 °C, or 37 °C. Our data indicate that the lyophilized reagents remain stable for 24 months when stored at 4 °C, 28 days at 25 °C, and 2 days at 37 °C. This improved LAMP assay can be easily performed in a simple water bath or heating block. The stability at ambient temperature, the simplicity of assay procedure, and the availability of low cost equipment make this method ideal for use in resource-limited settings where Q fever is endemic.
Collapse
Affiliation(s)
- Hua-Wei Chen
- Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States
| | - Wei-Mei Ching
- Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States
| |
Collapse
|
25
|
Kiattibutr K, Roobsoong W, Sriwichai P, Saeseu T, Rachaphaew N, Suansomjit C, Buates S, Obadia T, Mueller I, Cui L, Nguitragool W, Sattabongkot J. Infectivity of symptomatic and asymptomatic Plasmodium vivax infections to a Southeast Asian vector, Anopheles dirus. Int J Parasitol 2017; 47:163-170. [PMID: 28043858 PMCID: PMC5725394 DOI: 10.1016/j.ijpara.2016.10.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 10/06/2016] [Accepted: 10/12/2016] [Indexed: 12/13/2022]
Abstract
Plasmodium vivax is now the predominant species causing malarial infection and disease in most non-African areas, but little is known about its transmission efficiency from human to mosquitoes. Because the majority of Plasmodium infections in endemic areas are low density and asymptomatic, it is important to evaluate how well these infections transmit. Using membrane feeding apparatus, Anopheles dirus were fed with blood samples from 94 individuals who had natural P. vivax infections with parasitemias spanning four orders of magnitude. We found that the mosquito infection rate was positively correlated with blood parasitemia and that infection began to rise when parasitemia was >10parasites/μl. Below this threshold, mosquito infection is rare and associated with very few oocysts. These findings provide useful information for assessing the human reservoir of transmission and for establishing diagnostic sensitivity required to identify individuals who are most infective to mosquitoes.
Collapse
Affiliation(s)
- Kirakorn Kiattibutr
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wanlapa Roobsoong
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Patchara Sriwichai
- Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Teerawat Saeseu
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nattawan Rachaphaew
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chayanut Suansomjit
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Sureemas Buates
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Thomas Obadia
- Malaria: Parasites & Hosts Unit, Department of Parasites & Insect Vectors, Institut Pasteur, Paris, France; Bioinformatics and Biostatistics Hub, Institut Pasteur, Paris, France
| | - Ivo Mueller
- Malaria: Parasites & Hosts Unit, Department of Parasites & Insect Vectors, Institut Pasteur, Paris, France; Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Liwang Cui
- Department of Entomology, Pennsylvania State University, University Park, PA, USA
| | - Wang Nguitragool
- Department of Molecular Tropical Medicine & Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Jetsumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
26
|
Chahar M, Mishra N, Anvikar A, Dixit R, Valecha N. Establishment and application of a novel isothermal amplification assay for rapid detection of chloroquine resistance (K76T) in Plasmodium falciparum. Sci Rep 2017; 7:41119. [PMID: 28134241 PMCID: PMC5278370 DOI: 10.1038/srep41119] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 12/14/2016] [Indexed: 02/08/2023] Open
Abstract
Chloroquine (CQ) resistance in Plasmodium falciparum is determined by the mutations in the chloroquine resistance transporter (Pfcrt) gene. The point mutation at codon 76 (K76T), which has been observed in more than 91% of P. falciparum isolates in India, is the major determinant of CQ resistance. To overcome the limitations and challenges of traditional methods, in this investigation we developed an easy to use loop mediated isothermal amplification (LAMP) protocol for rapid detection of the K76T mutation associated with CQ resistance in P. falciparum with naked eye visualization. In- house designed primers were synthesized and optimized to specifically distinguish the CQ resistant mutants of P. falciparum. The LAMP reaction was optimal at 61 °C for 60 min and calcein dye was added prior to amplification to enable visual detection. We demonstrate the detection limit of <2 ng/μl respectively, supporting the high sensitivity of this calcein based LAMP method. To the best of our knowledge this is the first report on the establishment of an easy, reliable and cost effective LAMP assay for rapid and specific detection of highly CQ resistance in P. falciparum malaria.
Collapse
Affiliation(s)
- Madhvi Chahar
- Division of Epidemiology & Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi, 110077, India
| | - Neelima Mishra
- Division of Epidemiology & Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi, 110077, India
| | - Anup Anvikar
- Division of Epidemiology & Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi, 110077, India
| | - Rajnikant Dixit
- Division of Epidemiology & Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi, 110077, India
| | - Neena Valecha
- Division of Epidemiology & Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi, 110077, India
| |
Collapse
|
27
|
Abstract
Point-of-care (POC) laboratories that deliver rapid diagnoses of infectious diseases were invented to balance the centralization of core laboratories. POC laboratories operate 24 h a day and 7 days a week to provide diagnoses within 2 h, largely based on immunochromatography and real-time PCR tests. In our experience, these tests are conveniently combined into syndrome-based kits that facilitate sampling, including self-sampling and test operations, as POC laboratories can be operated by trained operators who are not necessarily biologists. POC laboratories are a way of easily providing clinical microbiology testing for populations distant from laboratories in developing and developed countries and on ships. Modern Internet connections enable support from core laboratories. The cost-effectiveness of POC laboratories has been established for the rapid diagnosis of tuberculosis and sexually transmitted infections in both developed and developing countries.
Collapse
|
28
|
She R, Huang Y, Xu T, Guo Y. Challenges of research and development on antimalarial medicinal products in China: a bibliometric analysis and systematic review. Trans R Soc Trop Med Hyg 2016; 110:649-656. [PMID: 28158859 DOI: 10.1093/trstmh/trw083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 12/19/2016] [Indexed: 11/14/2022] Open
Abstract
Background The advancement in any antimalarial medicinal product including vaccines, drugs and diagnostics will have a vital influence on malaria elimination in China and on the global malaria control framework. This study aimed to identify research progress and challenges in China, hoping to better facilitate domestic elimination and for China to be more effectively involved in global malaria research and development. Methods A systematic search was conducted for research articles published from 2005 to 2014 in PubMed, CNKI and Wanfang using terms including malaria, diagnosis, drugs and vaccines. In total, 4259 articles from PubMed and 561 references from Chinese databases were included and categorized by topic. Results The literature from PubMed was clustered and seven antimalarial medicinal product research hotspots were identified; including drug resistance, diagnostic tests and vaccine antigen screening. The reports related to drugs accounted for the largest proportion in PubMed (57%) and Chinese studies (51%) while references associated with diagnostics accounted for the lowest proportion, 10% in PubMed and 14% in Chinese studies. Conclusions Despite continuous effort in malaria research and development, there exist gaps in progressive discoveries on malaria diagnostics and drugs in China. Successive focus on antimalarial medicinal products is essential to facilitate malaria control in China and worldwide.
Collapse
Affiliation(s)
- Rui She
- School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Yangmu Huang
- School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Tingting Xu
- School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Yan Guo
- School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| |
Collapse
|
29
|
Oriero EC, Okebe J, Jacobs J, Van Geertruyden JP, Nwakanma D, D'Alessandro U. Diagnostic performance of a novel loop-mediated isothermal amplification (LAMP) assay targeting the apicoplast genome for malaria diagnosis in a field setting in sub-Saharan Africa. Malar J 2015; 14:396. [PMID: 26450599 PMCID: PMC4599330 DOI: 10.1186/s12936-015-0926-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/29/2015] [Indexed: 11/30/2022] Open
Abstract
Background New diagnostic tools to detect reliably and rapidly asymptomatic and low-density malaria infections are needed as their treatment could interrupt transmission. Isothermal amplification techniques are being explored for field diagnosis of malaria. In this study, a novel molecular tool (loop-mediated isothermal amplification—LAMP) targeting the apicoplast genome of Plasmodium falciparum was evaluated for the detection of asymptomatic malaria-infected individuals in a rural setting in The Gambia. Methods A blood was collected from 341 subjects (median age 9 years, range 1–68 years) screened for malaria. On site, a rapid diagnostic test (RDT, SD Bioline Malaria Antigen P.f) was performed, thick blood films (TBF) slides for microscopy were prepared and dry blood spots (DBS) were collected on Whatman® 903 Specimen collection paper. The TBF and DBS were transported to the field laboratory where microscopy and LAMP testing were performed. The latter was done on DNA extracted from the DBS using a crude (methanol/heating) extraction method. A laboratory-based PCR amplification was done on all the samples using DNA extracted with the Qiagen kit and its results were taken as reference for all the other tests. Results Plasmodium falciparum malaria prevalence was 37 % (127/341) as detected by LAMP, 30 % (104/341) by microscopy and 37 % (126/341) by RDT. Compared to the reference PCR method, sensitivity was 92 % for LAMP, 78 % for microscopy, and 76 % for RDT; specificity was 97 % for LAMP, 99 % for microscopy, and 88 % for RDT. Area under the receiver operating characteristic (ROC) curve in comparison with the reference standard was 0.94 for LAMP, 0.88 for microscopy and 0.81 for RDT. Turn-around time for the entire LAMP assay was approximately 3 h and 30 min for an average of 27 ± 9.5 samples collected per day, compared to a minimum of 10 samples an hour per operator by RDT and over 8 h by microscopy. Conclusion The LAMP assay could produce reliable results the same day of the screening. It could detect a higher proportion of low density malaria infections than the other methods tested and may be used for large campaigns of systematic screening and treatment.
Collapse
Affiliation(s)
- Eniyou C Oriero
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia. .,Institute of Tropical Medicine, Antwerp, Belgium. .,International Health Unit, University of Antwerp, Antwerp, Belgium.
| | - Joseph Okebe
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia. .,Institute of Tropical Medicine, Antwerp, Belgium. .,International Health Unit, University of Antwerp, Antwerp, Belgium.
| | - Jan Jacobs
- Institute of Tropical Medicine, Antwerp, Belgium. .,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
| | | | - Davis Nwakanma
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | - Umberto D'Alessandro
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia. .,Institute of Tropical Medicine, Antwerp, Belgium. .,London School of Hygiene and Tropical Medicine, London, UK.
| |
Collapse
|
30
|
Roth JM, Korevaar DA, Leeflang MMG, Mens PF. Molecular malaria diagnostics: A systematic review and meta-analysis. Crit Rev Clin Lab Sci 2015; 53:87-105. [DOI: 10.3109/10408363.2015.1084991] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
31
|
Morris U, Khamis M, Aydin-Schmidt B, Abass AK, Msellem MI, Nassor MH, González IJ, Mårtensson A, Ali AS, Björkman A, Cook J. Field deployment of loop-mediated isothermal amplification for centralized mass-screening of asymptomatic malaria in Zanzibar: a pre-elimination setting. Malar J 2015; 14:205. [PMID: 25982190 PMCID: PMC4440539 DOI: 10.1186/s12936-015-0731-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/08/2015] [Indexed: 12/14/2022] Open
Abstract
Background Molecular tools for detection of low-density asymptomatic Plasmodium infections are needed in malaria elimination efforts. This study reports results from the hitherto largest implementation of loop-mediated isothermal amplification (LAMP) for centralized mass screening of asymptomatic malaria in Zanzibar. Methods Healthy individuals present and willing to participate in randomly selected households in 60 villages throughout Zanzibar were screened for malaria by rapid diagnostic tests (RDT). In 50 % of the study households, participants were asked to provide 60 μL of finger-prick blood for additional LAMP screening. LAMP was conducted in two centralized laboratories in Zanzibar, by trained technicians with limited or no previous experience of molecular methods. The LAMP assay was performed with LoopampTM MALARIA Pan/Pf Detection Kit (Eiken Chemical Company, Japan). Samples positive for Plasmodium genus (Pan)-LAMP were re-tested using Plasmodium falciparum-specific LAMP kits. Results Paired RDT and LAMP samples were available from 3983 individuals. The prevalence of asymptomatic malaria was 0.5 % (CI 95 % 0.1-0.8) and 1.6 % (CI 95 % 1.1-2.2) by RDT and Pan-LAMP, respectively. LAMP detected 3.4 (CI 95 % 2.2-5.2) times more Plasmodium positive samples than RDT. DNA contamination was experienced, but solved by repetitive decontamination of all equipment and reagents. Conclusions LAMP is a simple and sensitive molecular tool, and has potential in active surveillance and mass-screening programmes for detection of low-density asymptomatic malaria in pre-elimination settings. However, in order to deploy LAMP more effectively in field settings, protocols may need to be adapted for processing larger numbers of samples. A higher throughput, affordable closed system would be ideal to avoid contamination. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0731-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ulrika Morris
- Malaria Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Nobelsväg 16, 171 77, Stockholm, Sweden.
| | - Mwinyi Khamis
- Zanzibar Malaria Elimination Programme (ZAMEP), Ministry of Health, Zanzibar, Tanzania.
| | - Berit Aydin-Schmidt
- Malaria Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Nobelsväg 16, 171 77, Stockholm, Sweden.
| | - Ali K Abass
- Zanzibar Malaria Elimination Programme (ZAMEP), Ministry of Health, Zanzibar, Tanzania
| | - Mwinyi I Msellem
- Zanzibar Malaria Elimination Programme (ZAMEP), Ministry of Health, Zanzibar, Tanzania.
| | - Majda H Nassor
- Zanzibar Malaria Elimination Programme (ZAMEP), Ministry of Health, Zanzibar, Tanzania.
| | - Iveth J González
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland.
| | - Andreas Mårtensson
- Malaria Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Nobelsväg 16, 171 77, Stockholm, Sweden. .,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. .,Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
| | - Abdullah S Ali
- Zanzibar Malaria Elimination Programme (ZAMEP), Ministry of Health, Zanzibar, Tanzania.
| | - Anders Björkman
- Malaria Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Nobelsväg 16, 171 77, Stockholm, Sweden.
| | - Jackie Cook
- Malaria Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Nobelsväg 16, 171 77, Stockholm, Sweden. .,London School of Hygiene and Tropical Medicine, London, UK.
| |
Collapse
|
32
|
Dauner AL, Mitra I, Gilliland T, Seales S, Pal S, Yang SC, Guevara C, Chen JH, Liu YC, Kochel TJ, Wu SJL. Development of a pan-serotype reverse transcription loop-mediated isothermal amplification assay for the detection of dengue virus. Diagn Microbiol Infect Dis 2015; 83:30-6. [PMID: 26032430 PMCID: PMC7126901 DOI: 10.1016/j.diagmicrobio.2015.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 10/24/2022]
Abstract
During dengue outbreaks, acute diagnosis at the patient's point of need followed by appropriate supportive therapy reduces morbidity and mortality. To facilitate needed diagnosis, we developed and optimized a reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay that detects all 4 serotypes of dengue virus (DENV). We used a quencher to reduce nonspecific amplification. The assay does not require expensive thermocyclers, utilizing a simple water bath to maintain the reaction at 63 °C. Results can be visualized using UV fluorescence, handheld readers, or lateral flow immunochromatographic tests. We report a sensitivity of 86.3% (95% confidence interval [CI], 72.7-94.8%) and specificity of 93.0% (95% CI, 83.0-98.1%) using a panel of clinical specimens characterized by DENV quantitative reverse transcription-polymerase chain reaction. This pan-serotype DENV RT-LAMP can be adapted to field-expedient formats where it can provide actionable diagnosis near the patient's point of need.
Collapse
Affiliation(s)
- Allison L Dauner
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Indrani Mitra
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Theron Gilliland
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Sajeewane Seales
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Subhamoy Pal
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA.
| | | | | | | | | | - Tadeusz J Kochel
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Shuenn-Jue L Wu
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| |
Collapse
|
33
|
Abstract
OBJECTIVE To investigate the incidence of mixed-species (MS) malaria infection, and compare the results with microscopically confirmed cases of malaria. METHODS During 2010, blood spots collected from 371 clinically suspected cases of malaria were microscopically examined in a cross-sectional study. The DNA was extracted from the samples, and a nested polymerase chain reaction (PCR) was performed. The results obtained by the 2 methods were compared. RESULTS From the microscopic analysis it was determined that 369 samples (99.5%) were positive for Plasmodium falciparum (P. falciparum) and 2 were Plasmodium vivax (P. vivax) mono-infections. There were no mixed malaria infections. The PCR analysis, however, showed that in 7 cases (1.9%) the infection was caused by MS malaria comprising of P. falciparum and P. vivax, 2 of these representing the cases that were microscopically diagnosed as P. vivax mono-infections. All cases were negative for Plasmodium malariae, Plasmodium ovale, and Plasmodium knowlesi. CONCLUSION Mixed malaria infections are currently overlooked when using microscopy. The PCR assays are essential complementary techniques that should be used with microscopic examination of blood smears.
Collapse
Affiliation(s)
- Saad M Bin Dajem
- Department of Biology, Faculty of Science, King Khalid University, PO Box 9004, Abha, Kingdom of Saudi Arabia. Tel. +966 (17) 544804040. Fax. +966 (17) 2417851. E-mail.
| |
Collapse
|
34
|
Manning JE, Satharath P, Gaywee J, Lopez MN, Lon C, Saunders DL. Fighting the good fight: the role of militaries in malaria elimination in Southeast Asia. Trends Parasitol 2014; 30:571-81. [PMID: 25455566 DOI: 10.1016/j.pt.2014.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 11/26/2022]
Abstract
Despite significant progress in malaria control in the Greater Mekong Subregion (GMS), malaria is still endemic, with more than 30 million people infected annually. Important gaps remain in case management, service delivery, prevention, and vector control, particularly in hard-to-reach mobile populations. Rapidly evolving drug resistance has created a new urgency to move aggressively toward elimination. However, no clear and cost-effective strategy has been identified. Although GMS militaries are under-recognized as a malaria transmission reservoir, they are an important focal point for elimination activities, given their high mobility, frequent malaria exposure, and potential for asymptomatic carriage. At the same time, military organizational capacity and proximity to other mobile populations could facilitate elimination efforts if relevant political barriers could be overcome. Here, we review considerations for military involvement in regional malaria elimination efforts.
Collapse
Affiliation(s)
- Jessica E Manning
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | | | - Chanthap Lon
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; US Army Medical Component, Armed Forces Research Institute of Medical Sciences, Phnom Penh, Cambodia
| | - David L Saunders
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
| |
Collapse
|