Evaluation of loop-mediated isothermal amplification as a surveillance tool for malaria in reactive case detection moving towards elimination.
Evaluation of loop-mediated isothermal amplification as a surveillance tool for malaria in reactive case detection moving towards elimination.
复制标题
在反应性病例检测中，评估环路介导的等温扩增作为疟疾的监测工具。
DOI：
10.1186/s12936-018-2399-x
复制
发表时间：
2018-07-09
期刊：
影响因子：
3
通讯作者：
Mumbengegwi DR
中科院分区：
文献类型：
--
作者：
Tambo M;Auala JR;Sturrock HJ;Kleinschmidt I;Bock R;Smith JL;Gosling R;Mumbengegwi DR
随着疟疾传播的减少，在任何给定时间无症状的感染比例增加。这对诊断提出了挑战，因为常规使用的快速诊断检测（RDTs）由于敏感性差而错过了寄生虫密度低的无症状疟疾病例。然而，无症状感染可促进疟疾的进一步传播，因此充当传染病宿主并使疟疾传播永续下去。本研究比较了RDTs与环介导等温扩增（LAMP）在反应性主动病例检测监测中诊断疟疾的表现。纳米比亚恩杰拉卫生区报告的所有疟疾病例都追溯到其居住地，并对居住在离指示病例最近的四所邻近房屋（社区）内的人进行了疟疾感染检测，并收集了干血斑。对所有rdt和DBS进行LAMP和巢式PCR （nPCR）检测。在随机选择的对照社区遵循相同的程序。采用RDT、LAMP和nPCR对3151人进行了检测。与nPCR相比，rdt和LAMP的敏感性分别为9.30%和95.50%，特异性分别为99.27%和99.92%。与对DBS进行的nPCR相比，对收集的rdt进行LAMP检测的敏感性和特异性分别为95.35%和99.85%。有2份RDT样品LAMP检测为阴性，而相应的DBS样品PCR检测为阳性。研究表明，LAMP在恶性疟原虫感染的鉴定中具有与nPCR相当的性能。由于LAMP相对于更复杂和耗时的方法（如PCR）实施相对简单，因此在高灵敏度和易于操作的消除设置中特别有用。
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. 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. 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. 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.
登录
查看更多内容
影响因子：
56.3
作者：
Hay, Simon I.;Smith, David L.;Snow, Robert W.
通讯作者：
Snow, Robert W.
影响因子：
3.7
作者：
Smith, Jennifer L.;Auala, Joyce;Sturrock, Hugh J. W.
通讯作者：
Sturrock, Hugh J. W.
影响因子：
3
作者：
Sema M;Alemu A;Bayih AG;Getie S;Getnet G;Guelig D;Burton R;LaBarre P;Pillai DR
通讯作者：
Pillai DR
影响因子：
3
作者：
Britton S;Cheng Q;McCarthy JS
通讯作者：
McCarthy JS
影响因子：
6.4
作者：
Hopkins, Heidi;Bebell, Lisa;Dorsey, Grant
通讯作者：
Dorsey, Grant