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Loop-mediated isothermal amplification (LAMP) for point-of-care detection of asymptomatic low-density malaria parasite carriers in Zanzibar.

机译：回路介导的等温扩增（LAMP），用于在桑给巴尔岛上无症状的低密度疟原虫携带者的即时诊查。

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Asymptomatic, low parasite density malaria infections are difficult to detect with currently available point-of-care diagnostics. This study piloted a loop-mediated isothermal amplification (LAMP) kit for field-friendly, high-throughput detection of asymptomatic malaria infections during mass screening and treatment (MSAT) in Zanzibar, a malaria pre-elimination setting.MethodsScreening took place in three known hotspot areas prior to the short rains in November. Finger-prick blood was taken for screening by rapid diagnostic test (RDT) and LAMP and collected on filter paper for subsequent polymerase chain reaction (PCR) analyses. LAMP results were compared to RDT and to PCR using McNemar¿s test.ResultsApproximately 1,000 people were screened. RDT detected ten infections (1.0% (95% CI 0.3-1.6)) whilst both LAMP and PCR detected 18 (1.8% (95% CI 0.9-2.6)) infections. However, PCR identified three infections that LAMP did not detect and vice versa. LAMP testing was easy to scale-up in field conditions requiring minimal training and equipment, with results ready one to three hours after screeningConclusionsDespite lower than expected prevalence, LAMP detected a higher number of infections than the currently used diagnostic, RDT. LAMP is a field-friendly, sensitive diagnostic test that could be useful for MSAT malaria campaigns which require quick results to enable prompt treatment.
机译：使用当前可用的即时诊断服务很难检测到无症状，低寄生虫密度的疟疾感染。这项研究试验了一种环介导的等温扩增（LAMP）试剂盒，用于在疟疾预消除环境的桑给巴尔进行大规模筛查和治疗（MSAT）期间，以现场友好的高通量检测无症状疟疾感染的方法。 11月短雨之前的热点地区。手指刺血通过快速诊断测试（RDT）和LAMP进行筛查，并收集在滤纸上用于随后的聚合酶链反应（PCR）分析。使用McNemar检验将LAMP结果与RDT和PCR进行比较。结果筛选了约1,000人。 RDT检测到十次感染（1.0％（95％CI 0.3-1.6）），而LAMP和PCR检测到18次（1.8％（95％CI 0.9-2.6））感染。但是，PCR确定了LAMP未检测到的三种感染，反之亦然。 LAMP测试很容易在野外条件下进行扩展，只需要最少的培训和设备，筛查后一到三个小时就可以得出结论。结论尽管比预期的患病率低，但LAMP的感染数量要比当前使用的诊断RDT高。 LAMP是一种现场友好的敏感诊断测试，对于需要快速结果才能迅速进行治疗的MSAT疟疾运动可能很有用。

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