Folded sheets of waxed paper could now offer an alternative solution for testing for malaria in developing parts of the world.
Researchers have published a paper titled “Paper-based Microfluidics for Diagnosing Malaria in Low Resource Rural Environments,” describing how origami-style folded paper, prepared with a printer and hot plate, can help detect malaria with 98 percent sensitivity in infected participants.
Researchers from the University of Glasgow and Shanghai Jiao Tong University are working together with the Ministry of Health in Uganda.
Malaria is a leading cause of illness and death in the world, and affects more than 219 million people in 90 countries. In just 2017, the deadly disease killed 435,000 people.
One way to help prevent the spread of this disease is to diagnose individuals who are infected but do not show any symptoms. This can only be done by widespread field tests. However, current tests, which use a process known as polymerase chain reaction (PCR), can only be carried out in lab conditions. This makes it almost impossible for this to be done in remote locations.
Now, the team of researchers have developed a new approach to diagnosing malaria in settings other than a lab. The process uses paper to prepare patient samples with what’s known as loop-mediated isothermal amplification (LAMP). This provides a more portable means of diagnosing the disease and makes it accessible to remote parts of the developing world.
The origami paper uses a commercially available printer that coats the paper in patterns made from water-resistant wax, and is then melted on a hotplate, which bonds the wax to the paper.
Using a finger prick, a blood sample is taken from the patient and placed on the wax. The paper is then folded and directs the blood sample into a channel, which branches off into three smaller chambers. The LAMP machine tests the samples’ DNA for any evidence of Plasmodium falciparum, the mosquito parasite that causes malaria. This test can be done in 50 minutes or less, and can be completed on-site in any remote location.
“We tested our approach with volunteers from two primary schools in the Mayuge and Apac districts in Uganda,” said Professor Jonathan Cooper of the University of Glasgow’s School of Engineering is the paper’s lead author. “We took samples from 67 schoolchildren, under strict ethical approval, and ran diagnostic tests in the field using optical microscopy techniques, the gold standard method in these low-resource settings, a commercial rapid diagnostic procedure known as a lateral flow test and our LAMP approach. We also carried out PCR back in Glasgow, on samples collected in the field.”
“Our diagnostic approach correctly diagnosed malaria in 98 percent of the infected samples we tested, markedly more sensitive than both the microscopy and lateral flow tests, which delivered 86 percent and 83 percent respectively,” Cooper continued. “It’s a very encouraging result which suggests that our paper-based LAMP diagnostics could help deliver better, faster, more effective testing for malaria infections in areas which are currently underserved by available diagnostic techniques.”
Dr. Julien Reboud, from the University of Glasgow’s School of Engineering, also helped developed the diagnostic tool. She noted the challenges developing countries have in containing the disease, and said it was vital that a new means of technology help mitigate the deadly consequences of Malaria.
“These are challenging environments for any test of this type, with no access to the kinds of refrigeration, special equipment and training that more traditional diagnostic procedures require, so it’s very encouraging that the diagnostic techniques we’ve developed have proven to be so sensitive and reliable,” said Dr. Reboud. “With malaria infections on the increase in 13 affected countries according to a World Health Organization report released last year, it’s vital that new forms of diagnosis reach the people who need them, and we’re committed to developing our approach to paper-based LAMP diagnostics further after this encouraging study.”
