NINA-LAMP compared to microscopy, RDT, and nested PCR for the detection of imported malaria

Abu Naser Mohon; Lydia Da-Yeong Lee; Abebe Genetu Bayih; Asongna Folefoc; Dylan Guelig; Robert A Burton; Paul LaBarre; Wilson Chan; Bonnie Meatherall; Dylan R Pillai

doi:10.1016/j.diagmicrobio.2015.11.009

NINA-LAMP compared to microscopy, RDT, and nested PCR for the detection of imported malaria

Diagn Microbiol Infect Dis. 2016 Jun;85(2):149-53. doi: 10.1016/j.diagmicrobio.2015.11.009. Epub 2015 Nov 10.

Authors

Affiliations

¹ Department of Microbiology, Immunology and Infectious Disease, University of Calgary, AB, Canada; Department of Pathology and Laboratory Medicine, University of Calgary, AB, Canada.
² Department of Microbiology, Immunology and Infectious Disease, University of Calgary, AB, Canada.
³ Department of Pathology and Laboratory Medicine, University of Calgary, AB, Canada.
⁴ PATH, Seattle, WA, USA.
⁵ Department of Medicine, University of Calgary, Calgary, AB, Canada.
⁶ 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 Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: drpillai@ucalgary.ca.

Abstract

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.

Keywords: LAMP; Malaria; Point of care test.

Publication types

Comparative Study
Evaluation Study

MeSH terms

Chromatography, Affinity / methods*
Diagnostic Tests, Routine / methods*
Humans
Malaria / diagnosis*
Microscopy / methods*
Molecular Diagnostic Techniques / methods*
Point-of-Care Systems
Sensitivity and Specificity
Travel*

Grants and funding

R01 EB012641/EB/NIBIB NIH HHS/United States