Performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia
Performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia
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DOI：
10.1186/s12936-017-1692-4
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发表时间：
2017-01-19
期刊：
影响因子：
3
通讯作者：
Pillai, Dylan R.
中科院分区：
文献类型：
--
作者：
Tegegne, Banchamlak;Getie, Sisay;Pillai, Dylan R.
背景：疟疾是一个主要的公共卫生问题，也是包括埃塞俄比亚在内的撒哈拉以南非洲地区母婴发病率的重要原因。通过有效治疗及早准确诊断疟疾是预防和控制孕期并发症和婴儿发病率和死亡率的最佳战略。然而，实验室诊断依赖于使用Giemsa染色显微镜或快速诊断试验(RDT)识别疟疾寄生虫和外周血中的寄生虫抗原，这缺乏分析和临床敏感性。本研究旨在评价环介导等温扩增(LAMP)技术在埃塞俄比亚西北部疑似疟疾孕妇中诊断疟疾的效果。方法：于2016年1-4月进行横断面研究。在六个保健中心登记了87名疑似患有疟疾的孕妇。从每个研究对象采集静脉血样本，并通过显微镜、RDT和LAMP分析疟原虫。将显微镜、RDT和LAMP的诊断准确性结果指标(敏感性、特异性、预测值和Kappa评分)与巢式聚合酶链式反应(NPCR)作为金标准进行比较。结果：以nPCR为金标准，镜检法和RDT法的敏感性分别为90%和70%，特异性分别为98.7%和97.4%。LAMP检测的敏感性为100%，特异性为93.5%。结论：LAMP检测孕期疟疾的敏感性高于镜检和RDT。注意到在孕期疟疾的护理点检测中，LAMP提高了敏感性和易用性。LAMP需要在孕期间歇性筛查和治疗方案中进行进一步评估。
Background: Malaria is a major public health problem and an important cause of maternal and infant morbidity in sub-Saharan Africa, including Ethiopia. Early and accurate diagnosis of malaria with effective treatment is the best strategy for prevention and control of complications during pregnancy and infant morbidity and mortality. However, laboratory diagnosis has relied on the identification of malaria parasites and parasite antigens in peripheral blood using Giemsa-stained microscopy or rapid diagnostic tests (RDTs) which lack analytical and clinical sensitivity. The aim of this study was to evaluate the performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia.Methods: A cross sectional study was conducted from January to April 2016. Pregnant women (n = 87) suspected of having malaria at six health centres were enrolled. A venous blood sample was collected from each study subject, and analysed for Plasmodium parasites by microscopy, RDT, and LAMP. Diagnostic accuracy outcome measures (sensitivity, specificity, predictive values, and Kappa scores) of microscopy, RDT and LAMP were compared to nested polymerase chain reaction (nPCR) as the gold standard. Specimen processing and reporting times were documented.Results: Using nPCR as the gold standard technique, the sensitivity of microscopy and RDT was 90 and 70%, and the specificity was 98.7 and 97.4%, respectively. LAMP assay was 100% sensitive and 93.5% specific compared to nPCR.Conclusions: This study showed higher sensitivity of LAMP compared to microscopy and RDT for the detection of malaria in pregnancy. Increased sensitivity and ease of use with LAMP in point-of-care testing for malaria in pregnancy was noted. LAMP warrants further evaluation in intermittent screening and treatment programmes in pregnancy.