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Loop-mediated isothermal DNA amplification for asymptomatic malaria detection in challenging field settings: Technical performance and pilot implementation in the Peruvian Amazon

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dc.contributor.author Serra-Casas, Elisa
dc.contributor.author Manrique, Paulo
dc.contributor.author Ding, Xavier C.
dc.contributor.author Carrasco-Escobar, Gabriel
dc.contributor.author Alava, Freddy
dc.contributor.author Gave, Anthony
dc.contributor.author Rodriguez, Hugo
dc.contributor.author Contreras-Mancilla, Juan
dc.contributor.author Rosas-Aguirre, Angel
dc.contributor.author Speybroeck, Niko
dc.contributor.author González, Iveth J.
dc.contributor.author Rosanas-Urgell, Anna
dc.contributor.author Gamboa, Dionicia
dc.date.accessioned 2019-01-25T15:28:05Z
dc.date.available 2019-01-25T15:28:05Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4694
dc.description.abstract BACKGROUND: Loop-mediated isothermal DNA amplification (LAMP) methodology offers an opportunity for point-of-care (POC) molecular detection of asymptomatic malaria infections. However, there is still little evidence on the feasibility of implementing this technique for population screenings in isolated field settings. METHODS: Overall, we recruited 1167 individuals from terrestrial ('road') and hydric ('riverine') communities of the Peruvian Amazon for a cross-sectional survey to detect asymptomatic malaria infections. The technical performance of LAMP was evaluated in a subgroup of 503 samples, using real-time Polymerase Chain Reaction (qPCR) as reference standard. The operational feasibility of introducing LAMP testing in the mobile screening campaigns was assessed based on field-suitability parameters, along with a pilot POC-LAMP assay in a riverine community without laboratory infrastructure. RESULTS: LAMP had a sensitivity of 91.8% (87.7-94.9) and specificity of 91.9% (87.8-95.0), and the overall accuracy was significantly better among samples collected during road screenings than riverine communities (p≤0.004). LAMP-based diagnostic strategy was successfully implemented within the field-team logistics and the POC-LAMP pilot in the riverine community allowed for a reduction in the turnaround time for case management, from 12-24 hours to less than 5 hours. Specimens with haemolytic appearance were regularly observed in riverine screenings and could help explaining the hindered performance/interpretation of the LAMP reaction in these communities. CONCLUSIONS: LAMP-based molecular malaria diagnosis can be deployed outside of reference laboratories, providing similar performance as qPCR. However, scale-up in remote field settings such as riverine communities needs to consider a number of logistical challenges (e.g. environmental conditions, labour-intensiveness in large population screenings) that can influence its optimal implementation. en_US
dc.language.iso eng
dc.publisher PLoS
dc.relation.ispartof urn:issn:1932-6203
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adolescent en_US
dc.subject Child en_US
dc.subject Child, Preschool en_US
dc.subject DNA, Protozoan/genetics en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Malaria/diagnosis/epidemiology/parasitology en_US
dc.subject Male en_US
dc.subject Peru/epidemiology en_US
dc.subject Pilot Projects en_US
dc.subject Plasmodium/genetics en_US
dc.subject Prevalence en_US
dc.subject Real-Time Polymerase Chain Reaction en_US
dc.title Loop-mediated isothermal DNA amplification for asymptomatic malaria detection in challenging field settings: Technical performance and pilot implementation in the Peruvian Amazon en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0185742
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08


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