Mohon Abu Naser, Lee Lydia Da-Yeong, Bayih Abebe Genetu, Folefoc Asongna, Guelig Dylan, Burton Robert A, LaBarre Paul, Chan Wilson, Meatherall Bonnie, Pillai Dylan R
Department of Microbiology, Immunology and Infectious Disease, University of Calgary, AB, Canada; Department of Pathology and Laboratory Medicine, University of Calgary, AB, Canada.
Department of Microbiology, Immunology and Infectious Disease, University of Calgary, AB, Canada.
Diagn Microbiol Infect Dis. 2016 Jun;85(2):149-53. doi: 10.1016/j.diagmicrobio.2015.11.009. Epub 2015 Nov 10.
Microscopy and field adaptable rapid diagnostic tests (RDTs) are not sensitive and specific in certain conditions such as poor training of microscopists, lack of electricity, or lower sensitivity in the detection of non-falciparum malaria. More sensitive point-of-care testing (POCT) would reduce delays in diagnosis and initiation of therapy. In the current study, we have evaluated the efficacy of noninstrumented nucleic acid amplification (NINA) coupled with loop-mediated isothermal amplification (LAMP) for detection of traveler's malaria (n=140) in comparison with microscopy, nested PCR, and the only Food and Drug Administration-approved rapid diagnostic test. NINA-LAMP was 100% sensitive and 98.6% specific when compared to nested PCR. For non-falciparum detection, NINA-LAMP sensitivity was 100% sensitive compared to nested PCR, whereas RDT sensitivity was 71%. LAMP is highly sensitive and specific for symptomatic malaria diagnosis regardless of species.
显微镜检查和现场适用的快速诊断检测(RDTs)在某些情况下并不敏感和特异,比如显微镜检查人员培训不足、缺乏电力,或者在检测非恶性疟原虫疟疾时灵敏度较低。更灵敏的即时检测(POCT)将减少诊断和治疗开始的延迟。在本研究中,我们评估了非仪器核酸扩增(NINA)结合环介导等温扩增(LAMP)用于检测输入性疟疾(n = 140)的效果,并与显微镜检查、巢式PCR以及唯一获得美国食品药品监督管理局批准的快速诊断检测进行了比较。与巢式PCR相比,NINA-LAMP的灵敏度为100%,特异性为98.6%。对于非恶性疟原虫的检测,与巢式PCR相比,NINA-LAMP的灵敏度为100%,而RDT的灵敏度为71%。无论疟原虫种类如何,LAMP对有症状疟疾的诊断都具有高度的敏感性和特异性。