Last Updated: 09/02/2021
Loop-mediated isothermal amplification (LAMP) for malaria detection in challenging field settings: Technical performance and pilot implementation in the Peruvian Amazon
Objectives
The main goal was to evaluate a malaria diagnostic strategy based on the use of LAMP Pan/Pf kits to detect asymptomatic infections, in the context of the population screening campaigns conducted by field-mobile teams (“brigadas”) in the Peruvian Amazon.
The specific objectives were:
-To analyze the performance of LAMP as a tool for detecting asymptomatic infections in this epidemiological context, compared to real-time PCR (as reference standard) and to the currently used diagnostic tool for screening campaigns (i.e. microscopy).
-To assess the operational feasibility of introducing this molecular tool in the routine procedures of the mobile field teams, including screenings in small communities only accessible by boat.
The LAMP methodology offers an opportunity for point-of-care (POC) molecular detection of asymptomatic malaria infections. However, there is still little evidence on the feasibility of implementing this technique for population screenings in isolated field settings.
This study showed that LAMP-based molecular malaria diagnosis can be deployed outside of reference laboratories, providing similar performance as qPCR. However, scale-up in remote field settings such as riverine communities needs to consider a number of logistical challenges (e.g. environmental conditions, labour-intensiveness in large population screenings) that can influence its optimal implementation.
The current national malaria control intervention in the area is based on Focal Screening and Treatment (FSAT) strategy, i.e. consecutive active case detection screenings in response to an unusual increase of reported cases in target communities. In this study, 1167 individuals from terrestrial and hydric communities were recruited for a cross-sectional survey to detect asymptomatic malaria infections. The technical performance of LAMP was evaluated in a subgroup of 503 samples, using qPCR as reference standard. The operational feasibility of introducing LAMP testing in the mobile screening campaigns was assessed based on field-suitability parameters, along with a pilot POC-LAMP assay in a riverine community without laboratory infrastructure.
Asymptomatic Reservoir
Diagnostics
Health Systems & Op. Research
Targeting Foci
Vulnerable Populations
Apr 2015 — Aug 2015
