title: Loop-mediated isothermal PCR (LAMP) for the diagnosis of falciparum malaria.
abstract: A recently described loop-mediated isothermal polymerase chain reaction (LAMP) for molecular detection of Plasmodium falciparum was compared with microscopy, PfHRP2-based rapid diagnostic test (RDT), and nested polymerase chain reaction (PCR) as the "gold standard" in 115 Bangladeshi in-patients with fever. DNA extraction for LAMP was conducted by conventional methods or simple heating of the sample; test results were either assessed visually or by gel electrophoresis. Conventional DNA extraction followed by gel electrophoresis had the highest agreement with the reference method (81.7%, kappa = 0.64), with a sensitivity (95% CI) of 76.1% (68.3-83.9%), comparable to RDT and microscopy, but a specificity of 89.6% (84.0-95.2%) compared with 100% for RDT and microscopy. DNA extraction by heat treatment deteriorated specificity to unacceptable levels. LAMP enables molecular diagnosis of falciparum malaria in settings with limited technical resources but will need further optimization. The results are in contrast with a higher accuracy reported in an earlier study comparing LAMP with a non-validated PCR method.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. parigi@tropmedres.ac
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Paris
authors.forename: Mallika
authors.initials: M
authors.lastname: Imwong
authors.forename: Abul M
authors.initials: AM
authors.lastname: Faiz
authors.forename: Mahtabuddin
authors.initials: M
authors.lastname: Hasan
authors.forename: Emran Bin
authors.initials: EB
authors.lastname: Yunus
authors.forename: Kamolrat
authors.initials: K
authors.lastname: Silamut
authors.forename: Sue J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Nicholas P J
authors.initials: NP
authors.lastname: Day
authors.forename: Arjen M
authors.initials: AM
authors.lastname: Dondorp
mesh_terms: D001459:Bangladesh; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis*; D008853:Microscopy; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity