title: Recombinase polymerase amplification combined with a lateral flow dipstick for rapid and visual detection of Schistosoma japonicum.
abstract: With the continuous decline in prevalence and intensity of Schistosoma japonicum infection in China, more accurate and sensitive methods suitable for field detection become much needed for schistosomiasis control. Here, a novel rapid and visual detection method based on the combination of recombinase polymerase amplification (RPA) and lateral flow dipstick (LFD) was developed to detect S. japonicum DNA in fecal samples.
  
  
  
  The LFD-RPA assay targeting SjR2 could detect 5 fg S. japonicum DNA, which was identical to qPCR and real-time RPA assay, and showed no cross-reaction with other parasites. The detection could be finished within 15-20 min at a wide temperature range (25-45 °C), and the results could be visualized by naked eye. The diagnostic validity of LFD-RPA assay was further assessed with 14 fecal samples of infected patients diagnosed by Kato-Katz method and 31 fecal samples of healthy persons, and compared with that of Enzyme-linked immunosorbent assay (ELSIA) and Indirect Hemagglutination Assay (IHA). The LFD-RPA assay showed 92.68 % sensitivity, 100 % specificity and excellent diagnostic agreement with the gold standard Kato-Katz test (k = 0.947, Z = 6.36, P < 0.001), whereas ELISA showed 85.71 % sensitivity, 93.55 % specificity, and substantial diagnostic agreement (k = 0.793, Z = 5.31, P < 0.001), and IHA showed 78.57 % sensitivity, 83.87 % specificity, and moderate diagnostic agreement (k = 0.600, Z = 4.05, P < 0.001), indicating that the LFD-RPA was much better than the traditional methods.
  
  
  
  The LFD-RPA assay established by us is a sensitive, specific, rapid and convenient method for the diagnosis of schistosomiasis, and shows a great potency in field application.
authors: Beijing Institute of Basic Medical Sciences, Beijing, People's Republic of China.
authors: Kui
authors: K
authors: Sun
authors: Beijing Institute of Basic Medical Sciences, Beijing, People's Republic of China.
authors: Weiwei
authors: W
authors: Xing
authors: The key laboratory of Immune and Control of Schistosomiasis, Hunan Institute of Parasitic Diseases, Hunan, People's Republic of China.
authors: Xinling
authors: X
authors: Yu
authors: Beijing Institute of Basic Medical Sciences, Beijing, People's Republic of China.
authors: Wenliang
authors: W
authors: Fu
authors: Beijing Institute of Basic Medical Sciences, Beijing, People's Republic of China.
authors: Yuanyuan
authors: Y
authors: Wang
authors: Beijing Institute of Basic Medical Sciences, Beijing, People's Republic of China.
authors: Minji
authors: M
authors: Zou
authors: The key laboratory of Immune and Control of Schistosomiasis, Hunan Institute of Parasitic Diseases, Hunan, People's Republic of China.
authors: Zhihong
authors: Z
authors: Luo
authors: Beijing Institute of Basic Medical Sciences, Beijing, People's Republic of China. xudg@bmi.ac.cn.
authors: Donggang
authors: D
authors: Xu
mesh_terms: D000818:Animals; D018509:DNA, Helminth / Q000235:genetics*; D006801:Humans; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D019095:Point-of-Care Systems; D016133:Polymerase Chain Reaction / Q000379:methods; D045522:Recombinases; D012549:Schistosoma japonicum / Q000302:isolation & purification*; D012554:Schistosomiasis japonica / Q000175:diagnosis* / Q000469:parasitology / Q000652:urine*; D012680:Sensitivity and Specificity
chemical_list: D018509:DNA, Helminth; D045522:Recombinases
keywords: Field application; Lateral flow dipstick; Recombinase polymerase amplification; Schistosoma japonicum; Visual detection