Field Evaluation of Malaria Microscopy, Rapid Malaria Tests and Loop-Mediated Isothermal Amplification in a Rural Hospital in South Western Ethiopia

Abstract

BackgroundIn up to one third of the hospitals in some rural areas of Africa, laboratory services in malaria diagnosis are limited to microscopy by thin film, as no capability to perform thick film exists (gold standard in terms of sensitivity for malaria diagnosis). A new rapid molecular malaria diagnostic test called Loop-mediated isothermal DNA amplification (LAMP) has been recently validated in clinical trials showing exceptional sensitivity and specificity features. It could be a reliable diagnostic tool to be implemented without special equipment or training.ObjectiveThe objective of this proof of concept study was to confirm the feasibility of using LAMP technique for diagnosis of malaria in a rural Ethiopian hospital with limited resources.Methodology/Principal FindingsThis study was carried out in Gambo General Hospital, West Arsi Province (Ethiopia), from November 1st to December 31st 2013. A total of 162 patients with a non-focal febrile syndrome were investigated. The diagnostic capability (sensitivity, specificity, positive predictive and negative predictive values) of rapid malaria tests and microscopy by thin film was evaluated in comparison with LAMP. Eleven (6.79%) out of the 162 patients with fever and suspected malaria, tested positive for LAMP, 3 (1.85%) for rapid malaria tests and none of the eleven cases was detected by thin film microscopy.Conclusions/SignificanceLAMP can be performed in basic rural laboratories without the need for specialized infrastructure and it may set a reliable tool for malaria control to detect a low level parasitemia.

Hemozoin detection may provide an inexpensive, sensitive, 1-minute malaria test that could revolutionize malaria screening

“…37,38 The accuracy of each method and startup costs vary widely within each method and therefore are not shown. Malaria detection methods run the gamut from very inexpensive and inaccurate (i.e., thin smear microscopy) to the highly accurate but extremely slow (i.e., PCR).…”

Sex determination in the wild: a field application of loop‐mediated isothermal amplification successfully determines sex across three raptor species

“…; Cuadros et al . ). However, despite this great potential, the application of LAMP in life and environmental sciences has been focused in species with commercial interest (Hsu et al .…”

“…LAMP is a relatively novel molecular technique for DNA amplification widely applied in medicine (Poon et al 2006;Fern andez-Soto et al 2014;Nyan et al 2014) and parasitology (Abbasi et al 2010;Salant et al 2012;Hamburger et al 2013). It does not require any molecular background nor experience, only a few days of training (Hamburger et al 2013;Cuadros et al 2015). However, despite this great potential, the application of LAMP in life and environmental sciences has been focused in species with commercial interest (Hsu et al 2011(Hsu et al , 2012Abdulmawjood et al 2014;Kim et al 2015).…”

LAMP kit for diagnosis of non-falciparum malaria in Plasmodium ovale infected patients

“…The boil and spin method [9] was used for extracting the DNA from frozen whole blood of all patients in a sample preparation area separated from the amplification area. Briefly, an aliquot of 60 μl of whole blood of each patient was transferred to the extraction tube and mixed with 60 μl of extraction buffer (400 mM NaCl, 40 mM Tris pH 6.5, 0.4% SDS) by vortex for 10 s. Extraction tubes containing the samples were placed in a hot-block (Techne DRI-Block DB) at 95 °C for 5 min, and were subsequently centrifuged at 10,000 g for 3 min (Jouan MR23).…”