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

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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Publication Details

Journal
Nature Communications
Published
2025-10-10
DOI
https://doi.org/10.1038/s41467-025-64027-4
Citations
2
Primary Topic
Malaria Research and Control
Type
article
Field-Weighted Citation Impact
3.76

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article

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

Dennis Odai Laryea, Muzamil Mahdi Abdel Hamid, Talya Porat, Shunmay Yeung et al.
2 citations
Nature Communications
Malaria Research and Control
3.76
article

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

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

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.

Nature CommunicationsVol. 16(1)
Canterbury Christ Church University (GB), University of Nairobi (KE), University of Ghana (GH), Institute of Cancer Research (GB), Malaria Consortium (GB), University of Khartoum (SD), Imperial College Healthcare NHS Trust (GB), Durham University (GB), Cancer Research UK (GB), Karolinska Institutet (SE), University of Energy and Natural Resources (GH), Bayan University (SD), Northrise University (ZM), UNSW Sydney (AU), London Biofoundry (GB), Dyson (United Kingdom) (GB), London School of Hygiene & Tropical Medicine (GB), Noguchi Memorial Institute for Medical Research (GH), MRC Unit the Gambia (GM), Institut Pasteur de Dakar (SN), Ghana Health Service (GH), National Institute of Public Administration (ZM), London Centre for Neglected Tropical Disease Research (GB), Institut de Recherche en Sciences de la Santé (BF), Imperial College London (GB), Royal College of Paediatrics and Child Health (GB), Masinde Muliro University of Science and Technology (KE), The Hague University of Applied Sciences (NL)
Wellcome Trust, Government of the United Kingdom, National Institute for Health Research Health Protection Research Unit, National Institute for Health and Care Research, Department of Health and Social Care, University of Warwick, Imperial College London, Imperial College Healthcare NHS Trust, Research England
Openalex Percentile: Top 6%
Malaria Research and Control
3.76
DOIOpen Access PDFOpenAlex
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