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Diagnostic performance of a Recombinant Polymerase Amplification Test-Lateral Flow (RPA-LF) for cutaneous leishmaniasis in an endemic setting of Colombia.

作者信息

Cossio Alexandra, Jojoa Jimena, Castro María Del Mar, Castillo Ruth Mabel, Osorio Lyda, Shelite Thomas R, Gore Saravia Nancy, Melby Peter C, Travi Bruno L

机构信息

Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.

Universidad Icesi, Cali, Colombia.

出版信息

PLoS Negl Trop Dis. 2021 Apr 28;15(4):e0009291. doi: 10.1371/journal.pntd.0009291. eCollection 2021 Apr.


DOI:10.1371/journal.pntd.0009291
PMID:33909619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8081229/
Abstract

BACKGROUND: Control of cutaneous leishmaniasis by public health systems in the Americas relies on case identification and treatment. Point-of-care diagnostics that can be performed by health workers within or near affected communities could effectively bring the health system to the resource-limited sites providing early diagnosis and treatment, reducing morbidity and the burden of disease. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was undertaken to evaluate the diagnostic test performance of Isothermal Recombinase Polymerase Amplification (RPA) targeting Leishmania kinetoplast DNA, coupled with a lateral flow (LF) immunochromatographic strip, in a field setting and a laboratory reference center. Minimally invasive swab and FTA filter paper samples were obtained by community health workers and highly trained technicians from ulcerated lesions of > 2 weeks' evolution from 118 patients' ≥ 2 years of age in the municipality of Tumaco, Nariño. Extracted DNA was processed by RPA-LF at a reference center or in a primary health facility in the field. Evaluation was based on a composite "gold standard" that included microscopy, culture, biopsy and real-time polymerase chain reaction detection of Leishmania 18S rDNA. Standard of care routine diagnostic tests were explored as comparators. Sensitivity and specificity of RPA-LF in the reference lab scenario were 87% (95%CI 74-94) and 86% (95%CI 74-97), respectively. In the field scenario, the sensitivity was 75% (95%CI 65-84) and specificity 89% (95%CI 78-99). Positive likelihood ratios in both scenarios were higher than 6 while negative likelihood ratios ranged to 0.2-0.3 supporting the usefulness of RPA-LF to rule-in and potentially to rule-out infection. CONCLUSIONS/SIGNIFICANCE: The low complexity requirements of RPA-LF combined with non-invasive sampling support the feasibility of its utilization by community health workers with the goal of strengthening the diagnostic capacity for cutaneous leishmaniasis in Colombia. TRIAL REGISTRATION: ClinicalTrials.gov NCT04500873.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ee/8081229/025d912bc28e/pntd.0009291.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ee/8081229/0387d79ebd80/pntd.0009291.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ee/8081229/9995880f37e1/pntd.0009291.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ee/8081229/025d912bc28e/pntd.0009291.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ee/8081229/0387d79ebd80/pntd.0009291.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ee/8081229/9995880f37e1/pntd.0009291.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ee/8081229/025d912bc28e/pntd.0009291.g003.jpg

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Diagnostic performance of a Recombinant Polymerase Amplification Test-Lateral Flow (RPA-LF) for cutaneous leishmaniasis in an endemic setting of Colombia.

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引用本文的文献

[1]
Recombinase-based amplification coupled with lateral flow chromatography for the specific and sensitive detection and identification of in cutaneous leishmaniasis patients.

Front Microbiol. 2025-1-27

[2]
Advances and Challenges in the Diagnosis of Leishmaniasis.

Mol Diagn Ther. 2025-3

[3]
qPCR as a Tool for the Diagnosis of Visceral and Cutaneous Leishmaniasis: A Systematic Review and Meta-Analysis.

Acta Parasitol. 2025-1-7

[4]
Effectiveness of Antileishmanial Treatments in Three Endemic Areas of Colombia: A Community-Based Cohort Study.

Am J Trop Med Hyg. 2024-10-8

[5]
Prehospital use of point-of-care tests by community health workers: a scoping review.

Front Public Health. 2024

[6]
Handheld Ultra-Fast Duplex Polymerase Chain Reaction Assays and Lateral Flow Detection and Identification of Parasites for Cutaneous Leishmaniases Diagnosis.

Pathogens. 2023-10-28

[7]
Smartphone-readable RPA-LFA for the high-sensitivity detection of Leishmania kDNA using nanophosphor reporters.

PLoS Negl Trop Dis. 2023-7

[8]
Diagnosis of Human Cutaneous Leishmaniasis: A Comparative Study Using CL Detect Dipstick, Direct Smear and Polymerase Chain Reaction Methods.

Acta Parasitol. 2023-6

[9]
Development and Characterization of Recombinase-Based Isothermal Amplification Assays (RPA/RAA) for the Rapid Detection of Monkeypox Virus.

Viruses. 2022-9-23

[10]
Novel CRISPR-based detection of species.

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本文引用的文献

[1]
Accuracy of diagnostic tests for American tegumentary leishmaniasis: a systematic literature review with meta-analyses.

Trop Med Int Health. 2020-10

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Am J Trop Med Hyg. 2020-6

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Parasite Epidemiol Control. 2019-3-7

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Am J Trop Med Hyg. 2018-7-5

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Malar J. 2018-5-18

[10]
Development and Evaluation of a Novel Loop-Mediated Isothermal Amplification Assay for Diagnosis of Cutaneous and Visceral Leishmaniasis.

J Clin Microbiol. 2018-6-25

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