Gauging the skin resident Leishmania parasites through a loop mediated isothermal amplification (LAMP) assay in post-kala-azar dermal leishmaniasis

Despite the availability of highly sensitive polymerase chain reaction (PCR)-based methods, the dearth of remotely deployable diagnostic tools circumvents the early and accurate detection of individuals with post-kala-azar dermal leishmaniasis (PKDL). Here, we evaluate a design-locked loop-mediated...

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Detalles Bibliográficos
Autores: Ghosh, Prakash, Chowdhury, Rajashree, Maruf, Shomik, Picado, Albert, Hossain, Faria, Owen, Sophie I, Nath, Rupen, Baker, James, Hasnain, Md Golam, Shomik, Mohammad Sohel, Ghosh, Debashis, Rashid, Masud, Rashid, Md Utba, Sagar, Soumik Kha, Rahat, Md Abu, Basher, Ariful, Nath, Proggananda, Edwards, Thomas, Andrews, Jason R, Duthie, Malcolm S, de Souza, Dziedzom K, Adams, Emily R, Ndung'u, Joseph Mathu, Cruz, Israel, Mondal, Dinesh
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/15944
Acceso en línea:http://hdl.handle.net/20.500.12105/15944
Access Level:acceso abierto
Palabra clave:Leishmaniasis, Visceral
Leishmania donovani
Parasites
Leishmaniasis, Cutaneous
Skin Diseases, Parasitic
Animals
Humans
Bayes Theorem
Real-Time Polymerase Chain Reaction
Descripción
Sumario:Despite the availability of highly sensitive polymerase chain reaction (PCR)-based methods, the dearth of remotely deployable diagnostic tools circumvents the early and accurate detection of individuals with post-kala-azar dermal leishmaniasis (PKDL). Here, we evaluate a design-locked loop-mediated isothermal amplification (LAMP) assay to diagnose PKDL. A total of 76 snip-skin samples collected from individuals with probable PKDL (clinical presentation and a positive rK39 rapid diagnostic test (RDT)) were assessed by microscopy, qPCR, and LAMP. An equal number of age and sex-matched healthy controls were included to determine the specificity of the LAMP assay. The LAMP assay with a Qiagen DNA extraction (Q-LAMP) showed a promising sensitivity of 72.37% (95% CI: 60.91-82.01%) for identifying the PKDL cases. LAMP assay sensitivity declined when the DNA was extracted using a boil-spin method. Q-qPCR showed 68.42% (56.75-78.61%) sensitivity, comparable to LAMP and with an excellent agreement, whereas the microscopy exhibited a weak sensitivity of 39.47% (28.44-51.35%). When microscopy and/or qPCR were considered the gold standard, Q-LAMP exhibited an elevated sensitivity of 89.7% (95% CI: 78.83-96.11%) for detection of PKDL cases and Bayesian latent class modeling substantiated the excellent sensitivity of the assay. All healthy controls were found to be negative. Notwithstanding the optimum efficiency of the LAMP assay towards the detection of PKDL cases, further optimization of the boil-spin method is warranted to permit remote use of the assay.

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