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

Article scientifique 2025 Anglais

Résumé

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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Robinson, D., Pennisi, I., Cavuto, M., Kiemdé, F., Chamai, M., Some, D., Quigley, E., Malpartida-Cardenas, K., Ndiath, M., Correa, S., Darboe, B., Stewart, L., Georgiou, P., Baldeh, M., Tinto, H., Cunnington, A., Erhart, A., D’Alessandro, U., Rodríguez-Manzano, J., Abdul-Tawab, A., Abdulai, J., Abumanga, M., Achan, J., Akogo, D., Amengu, A., Amoah, L., Anyaduba, T., Udofia, E., Awandare, G., Vroom, F., Baatiema, L., Baker, K., Baldeh, F., Balen, J., Baum, J., Baxter, W., Bonnington, C., Bukachi, S., Costelloe, C., Witte, L., Duodu, S., Dzabeng, F., Elnour, F., Fitchett, J., Gamil, S., Hachizovu, S., Hamade, P., Hamid, M., Herberg, J., Jebreel, W., Kabuya, J., Bawa, F., Kaforou, M., Laryea, D., Levin, M., Manyando, C., Mohamed, A., Dele-Olowu, S., Moser, N., Mwanza, S., Odoyo, E., Ofosuhemaa, P., Okell, L., Omer, A., Piffer, F., Porat, T., Sifuna, A., Sans, M., Bawah, F., Usuf, E., Yawson, A., Yeung, S., Sserwanga, A. (2025). Sensitive near point-of-care detection of asymptomatic and submicroscopic Plasmodium falciparum infections in African endemic countries. https://doi.org/10.1038/s41467-025-64027-4

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Auteur(s)

Dimbintsoa Rakotomalala Robinson Ivana Pennisi Matthew L. Cavuto François Kiemdé Martin Chamai Diane Yirgnur Some Elliot Quigley Kenny Malpartida-Cardenas Mamadou Ousmane Ndiath Simon Correa Bubacarr Darboe Lindsay B. Stewart Pantelis Georgiou Mamadu Baldeh Halidou Tinto Aubrey J. Cunnington Annette Erhart Umberto D’Alessandro Jesús Rodríguez-Manzano Azumah Abdul-Tawab Jamal‐Deen Abdulai Mohammed Abumanga Jane Achan Darlington Akogo Angelina Ankah Amengu Linda Eva Amoah Tochukwu Dubem Anyaduba Emilia Asuquo Udofia Gordon A. Awandare Frances Baaba da-Costa Vroom Leonard Baatiema K. Scott Baker Fatou Baldeh Julie Balen Jake Baum Weston Baxter Craig Bonnington Salome A. Bukachi Céire Costelloe Luc P. de Witte Samuel Duodu Francis Dzabeng Fahad A. Elnour Joe Fitchett Sahar Gamil Sebastian Hachizovu Prudence Hamade Muzamil Mahdi Abdel Hamid Jethro Herberg Waleed M. A. Jebreel Jean-Bertin Bukasa Kabuya Flavia Kaduni Bawa Myrsini Kaforou Dennis Odai Laryea Michael Levin Christine Manyando Abdelrahim Mohamed Shola K. Molemodile Dele-Olowu Nicolas Moser Sydney Mwanza Erick Odoyo Patience Ofosuhemaa Lucy Okell Abubakr A. M. Omer Francesca M. Piffer Talya Porat Anthony Wawire Sifuna Maria Suau Sans Faiza Umar Bawah Effua Usuf Alfred Edwin Yawson Shunmay Yeung Asadu Sserwanga

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