NINA-LAMP compared to microscopy, RDT, and nested PCR for the detection of imported malaria

Abstract Microscopy and field adaptable rapid diagnostic tests (RDTs) are not sensitive and specific in certain conditions such as poor training of microscopists, lack of electricity, or the inability to detect non- falciparum malaria. More sensitive point of care testing (POCT) would reduce delays in diagnosis and initiation of therapy. In the current study, we have evaluated the efficacy of non-instrumented nucleic acid amplification (NINA) coupled with LAMP for detection of traveler’s malaria (n = 140) in comparison with microscopy, nested PCR, and the only FDA-approved rapid diagnostic test. NINA-LAMP was 100% sensitive and 98.6% specific when compared to nested PCR. For non- falciparum detection, NINA-LAMP sensitivity was 100% sensitive compared to nested PCR whereas RDT sensitivity was 71%. LAMP is highly sensitive and specific for symptomatic malaria diagnosis regardless of species in a POCT setting.