title: Loop-mediated isothermal amplification (LAMP) for point-of-care detection of asymptomatic low-density malaria parasite carriers in Zanzibar.
abstract: BACKGROUND
  Asymptomatic, low parasite density malaria infections are difficult to detect with currently available point-of-care diagnostics. This study piloted a loop-mediated isothermal amplification (LAMP) kit for field-friendly, high-throughput detection of asymptomatic malaria infections during mass screening and treatment (MSAT) in Zanzibar, a malaria pre-elimination setting.
  
  
  METHODS
  Screening took place in three known hotspot areas prior to the short rains in November. Finger-prick blood was taken for screening by rapid diagnostic test (RDT) and LAMP and collected on filter paper for subsequent polymerase chain reaction (PCR) analyses. LAMP results were compared to RDT and to PCR using McNemar's test.
  
  
  RESULTS
  Approximately 1,000 people were screened. RDT detected ten infections (1.0% (95% CI 0.3-1.6)) whilst both LAMP and PCR detected 18 (1.8% (95% CI 0.9-2.6)) infections. However, PCR identified three infections that LAMP did not detect and vice versa. LAMP testing was easy to scale-up in field conditions requiring minimal training and equipment, with results ready one to three hours after screening.
  
  
  CONCLUSIONS
  Despite lower than expected prevalence, LAMP detected a higher number of infections than the currently used diagnostic, RDT. LAMP is a field-friendly, sensitive diagnostic test that could be useful for MSAT malaria campaigns which require quick results to enable prompt treatment.
authors: Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, SE-171 77, Sweden. Jackie.Cook@lshtm.ac.uk.
authors: Jackie
authors: J
authors: Cook
authors: Berit
authors: B
authors: Aydin-Schmidt
authors: Iveth J
authors: IJ
authors: González
authors: David
authors: D
authors: Bell
authors: Elin
authors: E
authors: Edlund
authors: Majda H
authors: MH
authors: Nassor
authors: Mwinyi
authors: M
authors: Msellem
authors: Abdullah
authors: A
authors: Ali
authors: Ali K
authors: AK
authors: Abass
authors: Andreas
authors: A
authors: Mårtensson
authors: Anders
authors: A
authors: Björkman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D001769:Blood / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D005260:Female; D057166:High-Throughput Screening Assays / Q000379:methods; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D013636:Tanzania; D055815:Young Adult
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