Abstract

Asymptomatic leishmaniasis cases have continuously increased, especially among patients with HIV who are at risk to develop further symptoms of cutaneous and visceral leishmaniasis. Thus, early diagnosis using a simple, sensitive and reliable diagnostic assay is important because populations at risk mostly reside in rural communities where laboratory equipment is limited. In this study, the highly sensitive and selective determination of Leishmania infection in asymptomatic HIV patients was achieved using dual indicators (SYBR safe and gold-nanoparticle probe; AuNP-probe) in one-step LAMP method based on basic instruments. The assay can be simply evaluated under the naked eye due to clear interpretation of fluorescent emission of LAMP-SYBR safe dye-complex and colorimetric precipitate of specific AuNP-probes. The sensitivities and specificities of fluorescent SYBR safe dye and AuNP-probe indicators were equal, which were as high as 94.1 and 97.1%, respectively. Additionally, detection limits were 102 parasites/mL (0.0147 ng/µL), ten times more sensitivity than other related studies. To empower leishmaniasis surveillance, this inexpensive one-step SYBR safe and AuNP-LAMP assay is reliably fast and simple for field diagnostics to point-of-care settings, which can be set up in all levels of health care facilities including resource limited areas, especially in low to middle income countries.

Highlights

  • Leishmaniasis, a vector-borne disease caused by flagellate protozoa of the genus Leishmania, remains one of the global health challenges affecting millions of people worldwide

  • We developed one-step loop-mediated isothermal amplification (LAMP) assay based on dual indicators for detection of Leishmania DNA in which AuNP probe was used as a second indicator of a closed tube SYBR safe-LAMP assay

  • The probe based on biotinylated loop primer could be used as simplified and generalized nanoprobes in any LAMP assays for specific verification, whereas SYBR safe could be used for general screening

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Summary

Introduction

Leishmaniasis, a vector-borne disease caused by flagellate protozoa of the genus Leishmania, remains one of the global health challenges affecting millions of people worldwide. We developed one-step LAMP assay based on dual indicators for detection of Leishmania DNA in which AuNP probe was used as a second indicator of a closed tube SYBR safe-LAMP assay. This simplified and inexpensive technique allowed rapid interpretation within a few minutes with high sensitivity and specificity. This additional step of AuNP-probe could improve and simplify the closed tube LAMP assay to empower asymptomatic leishmaniasis surveillance in HIV patients. This one-step LAMP assay is practical and useful for field diagnostics to point-of-care settings that is delivered to end-users, in low to middle income countries

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