EVALUATION OF LOOP MEDIATED ISOTHERMAL AMPLIFICATION KIT WITH GIEMSA MICROSCOPY FOR THE DIAGNOSIS OF MALARIA IN KOLA DIBA HEALTH CENTER, NORTHWEST ETHIOPIA

Abstract

Background: - Malaria is leading public health problem in the world especially in sub- Saharan African countries including Ethiopia. Early and accurate diagnosis followed by prompt and effective treatment is main strategy for prevention and control of malaria. Despite to this, current diagnostic methods such as Giemsa microscopy and rapid diagnostic tests could not produce reliable results. Hence, highly sensitive, specific and rapid molecular method of diagnosis is urgently needed. Objective: - To compare the performance of LAMP with Giemsa microscopy for the diagnosis of malaria at Kola Diba Health Center, Northwest Ethiopia from March 2014 to May 2014. Methods: A cross sectional study was conducted to evaluate LAMP performance with Giemsa microscopy in diagnosing malaria. Blood samples were collected from 200 consequently recruited malaria suspected study participants and examined for Plasmodium parasites using Giemsa microscopy. Fifty two malaria slide negative and thirty malaria slide positive individuals were included in LAMP evaluation study. Data was analyzed by SPSS version 20 and MedCalc online software. Primary outcome measures for diagnostic accuracy (sensitivity, specificity, and predictive value and Kappa value) of LAMP were computed and compared with Giemsa microscopy. Results: - Among 82 samples analyzed for LAMP assay, 38 samples were tested positive for genus plasmodium parasite and 26 were tested positive for P. falciparum parasite. Using Giemsa microscopy as reference method the sensitivity, specificity, positive and negative predictive values of LAMP assay were 100%, and 84.62%, 78.95% and 100%, respectively, for the Plasmodium genus primers. The LAMP result was also in very good agreement (κ = 0.91) with Giemsa microscopy for Plasmodium parasite detection. For P. falciparum primers, LAMP assay showed sensitivity and specificity of 100% and 81.16%, respectively with moderate agreement (κ = 0.577) for diagnosis of P. falciparum parasite. Conclusion: - The result of this study signifies that LAMP assay can be used as an alternative method for the diagnosis of malaria in control and elimination strategies in endemic areas. However, further onsite performance evaluation studies should be done in different settings to supplement this finding before implementing LAMP as malaria diagnostic method in Ethiopia.