Field-based molecular diagnostics: supporting the move towards test-and-treat scenarios in the elimination of urogenital schistosomiasis setting of Zanzibar

Molecular diagnostics can be highly sensitive and specific but most cannot be used at the point-of-care due to their high resource requirements. Recombinase polymerase amplification (RPA) is an isothermal DNA amplification technology offering several advantages in terms of its application in the endemic field setting.

This research is focused on the development of an RPA assay for Schistosoma haematobium, the cause of human urogential schistosomiasis, which can facilitate test- and-treat scenarios in the elimination setting of Zanzibar, Tanzania. The laboratory development of the assay proved its high sensitivity and specificity, with pilot testing on clinical samples showing a lower limit of detection of 1 egg/10ml of urine. Reactions are run at 40°C in small portable battery powered tube scanner devices and take just 10 minutes. Additionally, the development of crude sample preparations facilitate the assay’s feasibility in the endemic setting. Further research is ongoing to deploy this simple, portable, sensitive and specific technology to enable the testing and treating of the few individuals acting as reservoirs of infection Zanzibar.