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Am. J. Trop. Med. Hyg., 77(5), 2007, pp. 972-976
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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Loop-Mediated Isothermal PCR (LAMP) for the Diagnosis of Falciparum Malaria

Daniel H. Paris*, Mallika Imwong, Abul M. Faiz, Mahtabuddin Hasan, Emran Bin Yunus, Kamolrat Silamut, Sue J. Lee, Nicholas P. J. Day, AND Arjen M. Dondorp
Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom

A recently described loop-mediated isothermal polymerase chain reaction (LAMP) for molecular detection of Plasmodium falciparum was compared with microscopy, PfHRP2-based rapid diagnostic test (RDT), and nested polymerase chain reaction (PCR) as the "gold standard" in 115 Bangladeshi in-patients with fever. DNA extraction for LAMP was conducted by conventional methods or simple heating of the sample; test results were either assessed visually or by gel electrophoresis. Conventional DNA extraction followed by gel electrophoresis had the highest agreement with the reference method (81.7%, {kappa} = 0.64), with a sensitivity (95% CI) of 76.1% (68.3–83.9%), comparable to RDT and microscopy, but a specificity of 89.6% (84.0–95.2%) compared with 100% for RDT and microscopy. DNA extraction by heat treatment deteriorated specificity to unacceptable levels. LAMP enables molecular diagnosis of falciparum malaria in settings with limited technical resources but will need further optimization. The results are in contrast with a higher accuracy reported in an earlier study comparing LAMP with a non-validated PCR method.

Received April 2, 2007. Accepted for publication July 20, 2007.

Acknowledgments: DHP was supported by the Swiss National Science Foundation in 2005/06 (Grant PBZHB-106270) and now holds a Wellcome Trust Clinical Research Training Fellowship. This study was funded by the Wellcome Trust of Great Britain as part of the Wellcome Trust–Mahidol University–Oxford Tropical Medicine Research Programme.

Disclosure: The authors state that they have no conflict of interest.

* Address correspondence to Daniel H. Paris, Mahidol University, 420/6 Rajvithi Road, Bangkok 10500, Thailand. E-mail: parigi{at}tropmedres.ac

Authors’ addresses: All authors, Mahidol, Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, 10400 Bangkok, Thailand, Telephone: 66-2-3541395, Fax: 66-2-3549169, E-mails: parigi{at}tropmedres.ac, noi{at}tropmedres.ac, oye{at}tropmedres.ac, sue{at}tropmedres.ac, nickd{at}tropmedres.ac, arjen{at}tropmedres.ac, a.faiz{at}abnetbd.com, mahtab{at}abnetbd.com, emran{at}spnetctg.com.

Reprint requests: Daniel H. Paris, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand, Telephone: 66-2-354-91-71, Fax: 66-2-354-91-69, E-mail: parigi{at}tropmedres.ac.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.