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J Infect Dis. 2013 Aug 15;208(4):637-44. doi: 10.1093/infdis/jit183. Epub 2013 Apr 30.

Clinical evaluation of a loop-mediated amplification kit for diagnosis of imported malaria.

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  • 1Department of Clinical Parasitology, Walk-in Clinic, Hospital for Tropical Diseases, University London Colleges NHS Foundation Trust, Mortimer Market, London WC1E 6JB, UK.

Abstract

BACKGROUND:

Diagnosis of malaria relies on parasite detection by microscopy or antigen detection; both fail to detect low-density infections. New tests providing rapid, sensitive diagnosis with minimal need for training would enhance both malaria diagnosis and malaria control activities. We determined the diagnostic accuracy of a new loop-mediated amplification (LAMP) kit in febrile returned travelers.

METHODS:

The kit was evaluated in sequential blood samples from returned travelers sent for pathogen testing to a specialist parasitology laboratory. Microscopy was performed, and then malaria LAMP was performed using Plasmodium genus and Plasmodium falciparum-specific tests in parallel. Nested polymerase chain reaction (PCR) was performed on all samples as the reference standard. Primary outcome measures for diagnostic accuracy were sensitivity and specificity of LAMP results, compared with those of nested PCR.

RESULTS:

A total of 705 samples were tested in the primary analysis. Sensitivity and specificity were 98.4% and 98.1%, respectively, for the LAMP P. falciparum primers and 97.0% and 99.2%, respectively, for the Plasmodium genus primers. Post hoc repeat PCR analysis of all 15 tests with discrepant results resolved 4 results in favor of LAMP, suggesting that the primary analysis had underestimated diagnostic accuracy.

CONCLUSIONS:

Malaria LAMP had a diagnostic accuracy similar to that of nested PCR, with a greatly reduced time to result, and was superior to expert microscopy.

KEYWORDS:

LAMP; diagnostics; malaria

PMID:
23633403
[PubMed - indexed for MEDLINE]
PMCID:
PMC3719897
Free PMC Article
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