A field-deployable test demonstrates high sensitivity in identifying low-level infections that traditional methods miss, potentially supporting elimination efforts.
A low-cost, rapid molecular testing platform has demonstrated the ability to identify previously undetectable asymptomatic malaria infections in field studies conducted in Africa, according to research published in Nature Communications.
The Dragonfly platform, developed by ProtonDx based on technology from Imperial College London, requires only a capillary blood sample from a finger prick and delivers results in under 45 minutes without extensive laboratory infrastructure.
The study evaluated the platform’s performance using samples from endemic countries and found it detected more than 95% of all malaria infections, including 95% of cases where parasite levels were too low for detection by microscopy or lateral-flow devices. The test correctly identified 96.8% of uninfected samples and achieved a detection limit of 0.6 parasites/μL of capillary blood.
“This is the first time that a diagnostic test for use outside of a laboratory setting has proven sensitive enough to detect low-level malaria parasite infections in people who don’t have any symptoms,” says Aubrey Cunnington, professor in Imperial’s Department of Infectious Disease, in a release. “These people are the main source of malaria transmission.”
Meeting Performance Criteria for Community Screening
The platform meets performance criteria proposed by the Malaria Eradication Research Agenda for community-level screening. Asymptomatic carriers often sustain ongoing malaria transmission, hampering global health efforts to combat the disease. Approximately 95% of malaria fatalities occur in Africa.
The research involved collaboration between Imperial College London, the MRC Unit The Gambia, and the Clinical Research Unit of Nanoro in Burkina Faso. The platform extracts high-purity nucleic acids and analyzes samples for pan-Plasmodium presence to confirm malaria infection, demonstrating performance comparable to laboratory-based methods.
The compact, battery-operated design makes the system suitable for deployment in communities with limited laboratory access. The platform can be manufactured at a fraction of the cost of other molecular testing systems, according to the researchers.
Scale-Up Efforts Underway
“The technology delivered represents a game changer for malaria control efforts,” says Dr Jesus Rodriguez-Manzano, ProtonDx co-founder and associate professor at Imperial College, in a release. “This research would not have been possible without the collaborative nature and all the organizations that took part in this study.”
The development team is working with the Africa Centres for Disease Control and Prevention to explore opportunities with local manufacturers for production and scale-up rooted in local capacity for deployment across Africa.
The research received support from the National Institute for Health and Care Research global health research funding, the Wellcome Trust CAMO-Net programme, the Fleming Initiative, the Jameel Fund for Infectious Disease Research and Innovation, and the Centre of Defence Pathology and jHub Med at the UK Ministry of Defence.
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