title: Performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia.
abstract: Malaria is a major public health problem and an important cause of maternal and infant morbidity in sub-Saharan Africa, including Ethiopia. Early and accurate diagnosis of malaria with effective treatment is the best strategy for prevention and control of complications during pregnancy and infant morbidity and mortality. However, laboratory diagnosis has relied on the identification of malaria parasites and parasite antigens in peripheral blood using Giemsa-stained microscopy or rapid diagnostic tests (RDTs) which lack analytical and clinical sensitivity. The aim of this study was to evaluate the performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia.
  
  
  
  A cross sectional study was conducted from January to April 2016. Pregnant women (n = 87) suspected of having malaria at six health centres were enrolled. A venous blood sample was collected from each study subject, and analysed for Plasmodium parasites by microscopy, RDT, and LAMP. Diagnostic accuracy outcome measures (sensitivity, specificity, predictive values, and Kappa scores) of microscopy, RDT and LAMP were compared to nested polymerase chain reaction (nPCR) as the gold standard. Specimen processing and reporting times were documented.
  
  
  
  Using nPCR as the gold standard technique, the sensitivity of microscopy and RDT was 90 and 70%, and the specificity was 98.7 and 97.4%, respectively. LAMP assay was 100% sensitive and 93.5% specific compared to nPCR.
  
  
  
  This study showed higher sensitivity of LAMP compared to microscopy and RDT for the detection of malaria in pregnancy. Increased sensitivity and ease of use with LAMP in point-of-care testing for malaria in pregnancy was noted. LAMP warrants further evaluation in intermittent screening and treatment programmes in pregnancy.
authors.affiliation: Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Banchamlak
authors.initials: B
authors.lastname: Tegegne
authors.affiliation: Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. sisaygetie@yahoo.com.
authors.forename: Sisay
authors.initials: S
authors.lastname: Getie
authors.affiliation: Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Wossenseged
authors.initials: W
authors.lastname: Lemma
authors.affiliation: Department of Pathology and Laboratory Medicine, Medicine, and Microbiology, University of Calgary, Calgary, AB, Canada.
authors.forename: Abu Naser
authors.initials: AN
authors.lastname: Mohon
authors.affiliation: Department of Pathology and Laboratory Medicine, Medicine, and Microbiology, University of Calgary, Calgary, AB, Canada. drpillai@ucalgary.ca.
authors.forename: Dylan R
authors.initials: DR
authors.lastname: Pillai
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008288:Malaria / Q000175:diagnosis*; D021141:Nucleic Acid Amplification Techniques / Q000592:standards*; D010961:Plasmodium / Q000302:isolation & purification*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Diagnostics; Malaria; Molecular; Pregnancy; RDT