Sensitive near point-of-care detection of asymptomatic and submicroscopic Plasmodium falciparum infections in African endemic countries.

IF 15.7 1区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Nature Communications Pub Date : 2025-10-10 DOI:10.1038/s41467-025-64027-4

Dimbintsoa Rakotomalala Robinson,Ivana Pennisi,Matthew L Cavuto,Francois Kiemde,Martin Chamai,Diane Yirgnur Some,Elliot Quigley,Kenny Malpartida-Cardenas,Mamadou O Ndiath,Simon Correa,Bubacarr Darboe,Lindsay B Stewart,Pantelis Georgiou,Mamadu Baldeh,Halidou Tinto,Aubrey J Cunnington,Annette Erhart,Umberto D'Alessandro,Jesus Rodriguez-Manzano,

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引用次数: 0

Abstract

Limited diagnostic capacity for detecting asymptomatic malaria infections with low parasite densities hinders elimination efforts in Africa. Here, we adapt a near point-of-care, LAMP-based diagnostic platform for malaria diagnosis using capillary blood. This Pan/Pf detection method meets the Malaria Eradication Research Agenda (malERA) criteria for community-level screening, with a limit of detection of 0.6 parasites/μL and a sample-to-result time under 45 minutes. We evaluate its performance on 672 capillary blood samples collected at the community level in The Gambia and Burkina Faso, including 146 Plasmodium falciparum positives confirmed by qPCR. The diagnostic platform achieved 95.2% sensitivity (95% CI: 90.4-98.1) and 96.8% specificity (95% CI: 94.9-98.0). It also detected 94.9% (130/137) of asymptomatic infections and 95.3% (41/43) of submicroscopic cases (<16 parasites/μL), outperforming expert microscopy (70.1% and 0%) and rapid diagnostic tests (49.6% and 4.7%). This field-deployable molecular diagnostic method offers a sensitive, scalable solution to support test-and-treat strategies for malaria elimination across Africa.

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非洲流行国家无症状和亚显微恶性疟原虫感染的近护理点敏感检测

检测寄生虫密度低的无症状疟疾感染的诊断能力有限，阻碍了非洲的消除工作。在这里，我们采用了一个近点护理，基于lamp的诊断平台，用于使用毛细血管血液进行疟疾诊断。Pan/Pf检测方法的检出限为0.6只/μL，检出时间小于45 min，符合疟疾根除研究议程（malERA）的社区筛查标准。我们对在冈比亚和布基纳法索社区收集的672份毛细血管血液样本进行了性能评估，其中146份经qPCR证实为恶性疟原虫阳性。该诊断平台的灵敏度为95.2% (95% CI: 90.4-98.1)，特异性为96.8% （95% CI: 94.9-98.0）。无症状感染者检出率为94.9%(130/137)，亚显微镜（<16寄生虫/μL）检出率为95.3%(41/43)，高于专家显微镜（70.1%）和快速诊断（49.6%）。这种可在现场部署的分子诊断方法提供了一种敏感的、可扩展的解决方案，以支持在整个非洲消除疟疾的检测和治疗战略。

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来源期刊

Nature Communications Biological Science Disciplines-

CiteScore

24.90

自引率

2.40%

发文量

6928

审稿时长

3.7 months

期刊介绍： Nature Communications, an open-access journal, publishes high-quality research spanning all areas of the natural sciences. Papers featured in the journal showcase significant advances relevant to specialists in each respective field. With a 2-year impact factor of 16.6 (2022) and a median time of 8 days from submission to the first editorial decision, Nature Communications is committed to rapid dissemination of research findings. As a multidisciplinary journal, it welcomes contributions from biological, health, physical, chemical, Earth, social, mathematical, applied, and engineering sciences, aiming to highlight important breakthroughs within each domain.