Vera T. Unwin

Liverpool School of Tropical Medicine

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Emily R. Adams

Liverpool School of Tropical Medicine

Din Syafruddin

Hasanuddin University

María A. Santana-Morales

Universidad de La Laguna

Rukhsana Ahmed

Liverpool School of Tropical Medicine

Feiko O. ter Kuile

Kenya Medical Research Institute

Jeanne Rini Poespoprodjo

Menzies School of Health Research

Theda Lukito

Eijkman Institute for Molecular Biology

Sylvia S. Maratina

Eijkman Institute for Molecular Biology

Shaun Ainsworth

Hyperdrive Innovation (United Kingdom)

Agatha M. Puspitasari

Eijkman Institute for Molecular Biology

Cooperative Institutions

Liverpool School of Tropical Medicine

Eijkman Institute for Molecular Biology

University of Liverpool

National Research and Innovation Agency

Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo

Hasanuddin University

Nuffield Orthopaedic Centre

Ministry of Research, Technology and Higher Education

State University of Papua

Menzies School of Health Research

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Efficacy and safety of intermittent preventive treatment and intermittent screening and treatment versus single screening and treatment with dihydroartemisinin–piperaquine for the control of malaria in pregnancy in Indonesia: a cluster-randomised, open-label, superiority trial

The Lancet Infectious Diseases (2019)

Rukhsana Ahmed Jeanne Rini Poespoprodjo Din Syafruddin Carole Khairallah Cheryl Pace

Plasmodium falciparum and Plasmodium vivax infections are important causes of adverse pregnancy outcomes in the Asia-Pacific region. We hypothesised that monthly intermittent preventive treatment (IPT) or intermittent screening and treatment (IST) with dihydroartemisinin-piperaquine is more effective in reducing malaria in pregnancy than the existing single screening and treatment (SST) strategy, which is used to screen women for malaria infections at the first antenatal visit followed by passive case detection, with management of febrile cases.

Piperaquine

Dihydroartemisinin

10.1016/s1473-3099(19)30156-2

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Use of a highly-sensitive rapid diagnostic test to screen for malaria in pregnancy in Indonesia

Malaria Journal (2020)

Vera T. Unwin Rukhsana Ahmed Rintis Noviyanti Agatha M. Puspitasari Retno A. S. Utami

Abstract Background The sensitivity of rapid diagnostic tests (RDTs) for malaria is inadequate for detecting low-density, often asymptomatic infections, such as those that can occur when screening pregnant women for malaria. The performance of the Alere™ Ultra-sensitive Malaria Ag Plasmodium falciparum RDT (uRDT) was assessed retrospectively in pregnant women in Indonesia. Methods The diagnostic performance of the uRDT and the CareStart™ Malaria HRP2/pLDH VOM ( Plasmodium vivax, Plasmodium ovale and Plasmodium malariae ) Combo RDT (csRDT) were assessed using 270 stored red blood cell pellets and plasma samples from asymptomatic pregnant women. These included 112 P. falciparum negative and 158 P. falciparum positive samples detected by a composite test (qPCR, LAMP, nPCR) as reference standard. Diagnostic indicators: sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), diagnostic odds ratio (DOR) and the level of agreement (kappa) were calculated for comparison. Results Compared with the reference test, the uRDT had a sensitivity of 19.6% (95% CI 13.9–26.8) and specificity of 98.2% (93.1–99.7%). The csRDT was 22.8% (16.7–30.3) sensitive and 95.5% (89.4–98.3) specific for P. falciparum infections. Performance of the uRDT was non-significantly different to the csRDT (p = 0.169). RDT outcome was stratified by qPCR cycling threshold (Ct), and performance of the RDTs was found to be comparable across parasite loads. Conclusion The uRDT performed similarly to the currently used csRDTs in detecting P. falciparum infections in asymptomatic pregnant women. In these settings, molecular diagnostics are currently the most sensitive for malaria.

Rapid diagnostic test

Parasitology

Tropical Medicine

Diagnosis of malaria

Positive predicative value

Plasmodium malariae

Plasmodium ovale

10.1186/s12936-020-3110-6

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Development of a rapid field-applicable molecular diagnostic for knockdown resistance (kdr) markers in An. gambiae

Parasites & Vectors (2018)

Vera T. Unwin Shaun Ainsworth Emily J. Rippon El Hadji Amadou Niang Mark J. I. Paine

The spread of insecticide resistance (IR) is a major threat to vector control programmes for mosquito-borne diseases. Early detection of IR using diagnostic markers could help inform these programmes, especially in remote locations where gathering reliable bioassay data is challenging. Most current molecular tests for genetic IR markers are only suitable for use in well-equipped laboratory settings. There is an unmet need for field-applicable diagnostics. A single-cartridge test was designed to detect key IR mutations in the major African vector of malaria, Anopheles gambiae. Developed on the portable, rapid, point-of-care compatible PCR platform - Genedrive® (genedrive® plc), the test comprises two assays which target single nucleotide polymorphisms (SNPs) in the voltage gated sodium channel (VGSC) gene that exert interactive effects on knockdown resistance (kdr): L1014F, L1014S and N1575Y. Distinct melt peaks were observed for each allele at each locus. Preliminary validation of these assays using a test panel of 70 An. gambiae samples showed complete agreement of our assays with the widely-used TaqMan assays, achieving a sensitivity and specificity of 100%. Here we show the development of an insecticide resistance detection assay for use on the Genedrive® platform that has the potential to be the first field-applicable diagnostic for kdr.

Anopheles gambiae

TaqMan

Knockdown resistance

10.1186/s13071-018-2893-6

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Citations (3)