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Detection of pathogenic Leptospira with rapid extraction followed by recombinase polymerase amplification (RPA) and quantitative polymerase chain reaction (qPCR) assay-A comprehensive study from Sri Lanka

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dc.contributor.author Uduwawala, H.
dc.contributor.author Manamperi, A.
dc.contributor.author Gunaratna, G.P.S.
dc.contributor.author Karunanayake, L.
dc.contributor.author Ceruti, A.
dc.contributor.author Wahed, A.A.E.
dc.contributor.author Fernando, L.
dc.contributor.author Premaratna, R.
dc.contributor.author Hapugoda, M.
dc.date.accessioned 2024-03-21T04:55:48Z
dc.date.available 2024-03-21T04:55:48Z
dc.date.issued 2024
dc.identifier.citation PLoS One.2024;19(3):e0295287 en_US
dc.identifier.issn 1932-6203 (Electronic)
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/27784
dc.description Indexed in MEDLINE en_US
dc.description.abstract Leptospirosis is the most widespread zoonosis in the world. The disease is more prevalent in tropical regions where the majority of developing countries are located. Leptospirosis is considered a protean manifestation zoonosis with severity of the disease ranging from a mild febrile illness to a severe and life-threatening illness. Clinical symptoms of leptospirosis overlap with other tropical febrile illnesses. Early, rapid, and definitive diagnosis is important for effective patient management. Since Polymerase Chain Reaction (PCR)-based assays are not readily available in most clinical settings, there is a need for an affordable, simple, and rapid diagnostic test. Quantitative PCR (qPCR) and Recombinase Polymerase Amplification (RPA) were implemented at the Faculty of Medicine, University of Kelaniya, and a prospective study to evaluate RPA for diagnosis of acute phase of leptospirosis was conducted. Results indicate that RPA and qPCR were positive in 81% (98/121) of the total positive and acute clinical samples. Of the 81 positive MAT confirmed patients 60 (74%) and 53 (65%) were positive with qPCR and RPA respectively. Retrospective evaluation revealed a high diagnostic accuracy (sensitivity-70% and specificity-87%) of RPA compared to MAT as the reference gold standard. Results further suggest that there is no significant difference between the two assays, qPCR and RPA-SwiftX (P = 0.40). Laboratory procedures for the extraction and detection by qPCR in the laboratory have been optimized to obtain results within 6 hours. However, the RPA-SwiftX method under field conditions took 35 minutes. The RPA-SwiftX method could replace the qPCR which shows similar sensitivity and specificity. Therefore, RPA established under the current study presents a powerful tool for the early and rapid diagnosis of leptospirosis at point-of-care. en_US
dc.language.iso en en_US
dc.publisher Public Library of Science en_US
dc.subject polymerase en_US
dc.title Detection of pathogenic Leptospira with rapid extraction followed by recombinase polymerase amplification (RPA) and quantitative polymerase chain reaction (qPCR) assay-A comprehensive study from Sri Lanka en_US
dc.type Article en_US


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