Validation of a recombinase polymerase amplification assay for the diagnosis of female genital schistosomiasis in Zambian women using cervicovaginal lavage and vaginal self-swab samples

The BILHIV (Bilharzia and HIV) study, led by Dr Amaya Bustinduy at the London School of Hygiene & Tropical Medicine, was formed and aims to explore the innovative role of vaginal and cervical self-swabs for the diagnosis of FGS. Self-sampling with swabs is not only far less invasive than CVL sampling but can also be performed by the patient within the home. As part of the BILHIV study, it was recently shown that self-swab samples may be as sensitive, if not more sensitive, than CVL sampling when using qPCR to detect DNA derived from eggs sequestered throughout the genital tract.

The recently developed recombinase polymerase amplification (RPA) assay is a field-deployable DNA amplification technology and alternative to PCR. This study assessed the use of RPA for the detection of sequestered egg-derived DNA within CVL and vaginal self-swab samples; comparing RPA performance to that of qPCR. The work suggests that RPA may be a viable alternative to qPCR for the diagnosis of FGS and, if used in conjunction with self-swab samples, may provide a scalable solution in resource limited areas for the diagnosis of FGS at the point- of-care.