Rapid Malaria Diagnostic Tool Detects Asymptomatic Cases
A NEW near point-of-care malaria diagnostic has shown high sensitivity in identifying asymptomatic infections, a major obstacle to malaria elimination in Africa. Developed through collaboration between UK and West African institutions, this colourimetric loop-mediated isothermal amplification (LAMP)-based platform, known as Dragonfly, detects as few as 0.6 parasites per microlitre from a capillary blood sample, with a sample-to-result time of under 45 minutes.
In a field evaluation involving 672 community-collected blood samples in The Gambia and Burkina Faso, including 146 qPCR-confirmed Plasmodium falciparum infections, the diagnostic achieved 95.2% sensitivity (95% CI: 90.4–98.1) and 96.8% specificity (95% CI: 94.9–98.0). It detected 94.9% of asymptomatic infections and 95.3% of submicroscopic cases (<16 parasites/µL), substantially outperforming expert microscopy and rapid diagnostic tests (RDT).
These findings indicate that the assay meets Malaria Eradication Research Agenda (malERA) criteria for community-level screening and could support targeted “test-and-treat” strategies in endemic regions.
Field-Adapted Molecular Diagnostic Approach
The Dragonfly platform is designed for use in resource-limited settings. Using the SmartLid DNA extraction method, it allows testing from finger-prick capillary blood and can process up to 12 samples simultaneously. The system relies on isothermal amplification, avoiding the need for thermocyclers or fluorescent readers. All reagents are stored at room temperature, and results can be obtained within 1 hour using only basic laboratory equipment. When compared to existing commercial molecular tests, Dragonfly demonstrated comparable accuracy while offering practical advantages in throughput, portability, and cost. Its technical specifications align with many of the criteria outlined in malERA Target Product Profiles for community-level malaria screening and surveillance.
Future Evaluation and Implementation
Although the system remains at the prototype stage, further evaluations are planned to assess its performance under field conditions, including temperature stability and operational feasibility in decentralised community settings. Preliminary cost analyses suggest that the platform may offer a more affordable alternative to current commercial assays.
Future development will include local manufacturing partnerships in Africa and potential integration with digital health tools for surveillance and data management. If these evaluations confirm its reliability and practicality, this LAMP-based diagnostic could provide a scalable approach for identifying low-density infections that typically evade conventional testing methods.
Reference
Rakotomalala Robinson D et al. Sensitive near point-of-care detection of asymptomatic and submicroscopic Plasmodium falciparum infections in African endemic countries. Nat Commun. 2025;16:8925.
