Loop-Mediated Isothermal Amplification for Diagnosis of Zoonotic Malaria

Meng Yee Lai Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia;

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Ainaa Nadrah Sohairi Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia;

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Lee Phone Youth Zen Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia;

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Mohd Lutfi Abdullah National Wildlife Forensic Laboratory, Ex-Situ Conservation Division, Department of Wildlife and National Parks Peninsular Malaysia, Jalan Cheras, Kuala Lumpur, Malaysia

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Yee Ling Lau Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia;

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Zoonotic malaria, caused by Plasmodium knowlesi, Plasmodium cynomolgi, Plasmodium coatneyi, and Plasmodium inui, is a significant global health concern. The gold standard microscopy, while widely used for malaria diagnosis, faces limitations in differentiating between malaria species. Polymerase chain reaction (PCR), despite its accuracy, is characterized by high costs and time-consuming procedures. This study aims to develop and validate a rapid and accurate diagnostic test for detecting four simian Plasmodium species by using loop-mediated isothermal amplification (LAMP). Loop-mediated isothermal amplification is a cost-effective and faster molecular testing alternative for malaria diagnosis. The project involved designing specific primers, testing sensitivity and specificity against various parasites (including human Plasmodium species, protozoa, and helminths), and evaluating the LAMP assay using 60 macaque samples infected with simian Plasmodium. The LAMP assay exhibited a sensitivity profile enabling the detection of P. knowlesi, P. coatneyi, and P. cynomolgi across a concentration gradient from 5 × 108 down to 5 × 105 parasites/µL. Notably, P. inui was detectable at 5 × 108 parasites/µL. Furthermore, the specificity of the primer tailored for the four simian Plasmodium species was proven, as it produced a positive amplification exclusively for the respective target species and generated negative results for nontarget species. The results indicated that the LAMP assay is capable of detecting simian Plasmodium within a short span of 60 minutes, without any false positives from other samples. This new test has the potential to revolutionize malaria diagnosis, surveillance, and control, thereby mitigating the impact of zoonotic malaria in regions of endemicity.

Author Notes

Financial support: This study was funded by the Ministry of Higher Education Malaysia Long Term Research Grant Scheme (LRGS/1/2018/UM/01/1/4).

Disclosure: Ethical approval for the use of macaque blood for malaria screening was approved by the Institutional Animal Care and Use Committee Universiti Malaya (UM IACUC) (reference number M/06122019/25022019-01/R).

Authors’ contributions: M. Y. Lai and A. N. Sohairi prepared the manuscript; Y. L. Lau conceived the project; Y. L. Lau, M. Y. Lai, and L. P. Y. Zen conceptualized and planned the experiments; M. L. Abdullah, A. N. Sohairi, and L. P. Y. Zen prepared and processed samples and managed and performed the experiments; Y. L. Lau managed ethical clearance and logistic matters; A. N. Sohairi compiled, analyzed, and interpreted the data. All authors read and approved the final manuscript.

Current contact information: Meng Yee Lai, Ainaa Nadrah Sohairi, Lee Phone Youth Zen, Yee Ling Lau, and Mohd Lutfi Abdullah, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia, and Malaysia National Wildlife Forensic Laboratory, Ex-Situ Conservation Division, Department of Wildlife and National Parks Peninsular Malaysia, Jalan Cheras, Kuala Lumpur, Malaysia, E-mails: mengylai11@um.edu.my, ainaanadrah309@gmail.com, zen1py@hotmail.my, lauyeeling@um.edu.my, and lutfi@wildlife.gov.my.

Address correspondence to Yee Ling Lau, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia. E-mail: lauyeeling@um.edu.my
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