Sensitive near point-of-care detection of asymptomatic and submicroscopic Plasmodium falciparum infections in African endemic countries
Abstract
Abstract Limited diagnostic capacity for detecting asymptomatic malaria infections with low parasite densities hinders elimination efforts in Africa. Here, we adapt a near point-of-care, LAMP-based diagnostic platform for malaria diagnosis using capillary blood. This Pan/Pf detection method meets the Malaria Eradication Research Agenda (malERA) criteria for community-level screening, with a limit of detection of 0.6 parasites/μL and a sample-to-result time under 45 minutes. We evaluate its performance on 672 capillary blood samples collected at the community level in The Gambia and Burkina Faso, including 146 Plasmodium falciparum positives confirmed by qPCR. The diagnostic platform achieved 95.2% sensitivity (95% CI: 90.4–98.1) and 96.8% specificity (95% CI: 94.9–98.0). It also detected 94.9% (130/137) of asymptomatic infections and 95.3% (41/43) of submicroscopic cases (<16 parasites/μL), outperforming expert microscopy (70.1% and 0%) and rapid diagnostic tests (49.6% and 4.7%). This field-deployable molecular diagnostic method offers a sensitive, scalable solution to support test-and-treat strategies for malaria elimination across Africa.
Article Details
Authors (73)
Dimbintsoa Rakotomalala Robinson
Ivana Pennisi
Matthew L. Cavuto
Diane Yirgnur Some
Elliot Quigley
Kenny Malpartida-Cárdenas
Mamadou O. Ndiath
Simon Correa
Bubacarr Darboe
Mamadu Baldeh
Halidou Tinto
Annette Erhart
Umberto D’Alessandro
Francois Kiemde
Martin Chamai
Lindsay B. Stewart
Pantelis Georgiou
Aubrey J. Cunnington
Jesus Rodriguez-Manzano
Azumah Abdul-Tawab
Jamal-Deen Abdulai
Mohammed Abumanga
Jane Achan
Darlington A. Akogo
Angelina A. Amengu
Linda E. Amoah
Tochukwu D. Anyaduba
Emilia A. Udofia
Gordon A. Awandare
Frances B. da-Costa Vroom
Leonard Baatiema
Kevin Baker
Fatou Baldeh
Julie Balen
Jake Baum
Weston Baxter
Craig Bonnington
Salome A. Bukachi
Céire E. Costelloe
Luc P. de Witte
Samuel Duodu
Francis Dzabeng
Fahad A. Elnour
Joe Fitchett
Sahar Gamil
Sebastian S. Hachizovu
Prudence Hamade
Muzamil M. Abdel Hamid
Jethro A. Herberg
Waleed M. A. Jebreel
Jean-Bertin Kabuya
Flavia K. Bawa
Myrsini Kaforou
Dennis O. Laryea
Michael Levin
Christine Manyando
Abdelrahim O. Mohamed
Shola K. Molemodile Dele-Olowu
Nicolas Moser
Sydney Mwanza
Erick Odoyo
Patience Ofosuhemaa
Lucy C. Okell
Abubakr Omer
Francesca M. Piffer
Talya Porat
Anthony W. Sifuna
Maria Suau Sans
Faiza U. Bawah
Effua Usuf
Alfred E. Yawson
Shunmay Yeung
Asadu Sserwanga