title: Field Evaluation of Malaria Microscopy, Rapid Malaria Tests and Loop-Mediated Isothermal Amplification in a Rural Hospital in South Western Ethiopia.
abstract: BACKGROUND
  In up to one third of the hospitals in some rural areas of Africa, laboratory services in malaria diagnosis are limited to microscopy by thin film, as no capability to perform thick film exists (gold standard in terms of sensitivity for malaria diagnosis). A new rapid molecular malaria diagnostic test called Loop-mediated isothermal DNA amplification (LAMP) has been recently validated in clinical trials showing exceptional sensitivity and specificity features. It could be a reliable diagnostic tool to be implemented without special equipment or training.
  
  
  OBJECTIVE
  The objective of this proof of concept study was to confirm the feasibility of using LAMP technique for diagnosis of malaria in a rural Ethiopian hospital with limited resources.
  
  
  RESULTS
  This study was carried out in Gambo General Hospital, West Arsi Province (Ethiopia), from November 1st to December 31st 2013. A total of 162 patients with a non-focal febrile syndrome were investigated. The diagnostic capability (sensitivity, specificity, positive predictive and negative predictive values) of rapid malaria tests and microscopy by thin film was evaluated in comparison with LAMP. Eleven (6.79%) out of the 162 patients with fever and suspected malaria, tested positive for LAMP, 3 (1.85%) for rapid malaria tests and none of the eleven cases was detected by thin film microscopy.
  
  
  CONCLUSIONS
  LAMP can be performed in basic rural laboratories without the need for specialized infrastructure and it may set a reliable tool for malaria control to detect a low level parasitemia.
authors.affiliation: Department of Microbiology, Universitary Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Cuadros
authors.affiliation: Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.|Division of Infectious Diseases, Fundación Jiménez Díaz, Madrid, Spain.|Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.|Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Ramón
authors.initials: R
authors.lastname: Pérez-Tanoira
authors.affiliation: Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.|Division of Infectious Diseases, Fundación Jiménez Díaz, Madrid, Spain.|Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Prieto-Pérez
authors.affiliation: Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.|Medical Entomology Unit, Department of Parasitology, National Centre of Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain.
authors.forename: Ines
authors.initials: I
authors.lastname: Martin-Martin
authors.affiliation: National Centre of Tropical Medicine, Health Insitute Carlos III, Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Berzosa
authors.affiliation: National Centre of Tropical Medicine, Health Insitute Carlos III, Madrid, Spain.
authors.forename: Vicenta
authors.initials: V
authors.lastname: González
authors.affiliation: Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.
authors.forename: Gebre
authors.initials: G
authors.lastname: Tisiano
authors.affiliation: Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.
authors.forename: Seble
authors.initials: S
authors.lastname: Balcha
authors.affiliation: Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.|Department of Internal Medicine, Hospital General Universitario of Alicante.Miguel Hernández University, Elche, Alicante, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Ramos
authors.affiliation: Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.|Division of Infectious Diseases, Fundación Jiménez Díaz, Madrid, Spain.|Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Górgolas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016054:DNA, Protozoan / Q000032:analysis; D005002:Ethiopia; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis*; D008297:Male; D010963:Plasmodium falciparum / Q000235:genetics
chemical_list: D016054:DNA, Protozoan