Recombinase Polymerase Amplification Compared to Real-Time Polymerase Chain Reaction Test for the Detection ofFasciola hepaticain Human Stool.
Fasciola hepaticais the most widely distributed trematode infection in the world. Control efforts may be hindered by the lack of diagnostic capacity especially in remote endemic areas. Polymerase chain reaction (PCR)-based methods offer high sensitivity and specificity but require expensive technology. However, the recombinase polymerase amplification (RPA) is an efficient isothermal method that eliminates the need for a thermal cycler and has a high deployment potential to resource-limited settings. We report on the characterization of RPA and PCR tests to detectFasciolainfection in clinical stool samples with low egg burdens. The sensitivity of the RPA and PCR were 87% and 66%, respectively. Both tests were 100% specific showing no cross-reactivity with trematode, cestode, or nematode parasites. In addition, RPA and PCR were able to detect 47% and 26% of infections not detected by microscopy, respectively. The RPA adapted to a lateral flow platform was more sensitive than gel-based detection of the reaction products. In conclusion, theFasciolaRPA is a highly sensitive and specific test to diagnose chronic infection using stool samples. TheFasciolaRPA lateral flow has the potential for deployment to endemic areas after further characterization.
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas. micabada@utmb.edu.|Department of Medicine, Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Lima, Peru.|Universidad Peruana Cayetano Heredia-University of Texas Medical Branch Collaborative Research Center-Cusco, Cusco, Peru.
Miguel M
MM
Cabada
Department of Medicine, Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Lima, Peru.|Universidad Peruana Cayetano Heredia-University of Texas Medical Branch Collaborative Research Center-Cusco, Cusco, Peru.
Jose L
JL
Malaga
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Alejandro
A
Castellanos-Gonzalez
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Kelli A
KA
Bagwell
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Patrick A
PA
Naeger
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Hayley K
HK
Rogers
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Safa
S
Maharsi
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Maryann
M
Mbaka
Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
A Clinton
AC
White
D000818:Animals; D005210:Fasciola hepatica / Q000235:genetics; D005211:Fascioliasis / Q000175:diagnosis* / Q000469:parasitology; D005243:Feces / Q000469:parasitology*; D006801:Humans; D008853:Microscopy; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity