Supporting Sustainable Diagnostics in Low-Resource Settings using RT-LAMP - Technology Networks

Global public health is facing a funding crisis and uneven access to modern molecular technology, threatening public health initiatives against infectious diseases. NEB Executive Director of Research Thomas C. Evans, Jr., Ph.D., contributed an article to Technology Networks about sustainable diagnostics in low-resource settings with Alessandro Marcello, Ph.D., Head of the Laboratory of Molecular Virology at the International Centre for Genetic Engineering and Biotechnology (ICGEB).

NEB is one of several partners in the Expanding Access to Sustainably Diagnostics Africa (EXPANDIA) project, alongside ICGEB, other molecular technology developers, and clinical labs across Africa.

This article outlines EXPANDIA’s foundational steps to help them prove the cost-effectiveness of reverse transcription loop-mediated isothermal amplification (RT-LAMP) as an alternative to PCR:

• Conducting a diagnostic needs assessment, initiated by ICGEB, through partnering with regional labs to find local priorities and challenges. This found that many African community labs often only have a light microscope for malaria detection, and that electricity and nucleic acid extraction access is lacking or inconsistent.
• Searching for suitable molecular methods and development collaborators that could tailor nucleic acid amplification tests. ICGEB found that NEB was commercializing a colorimetric LAMP test for research use only, offering an affordable and easy to assess method.
• Tailoring colorimetric LAMP testing for the region through communication between NEB, ICGEB, and partnering regional labs. This was benefited by the dual readout system that allowed for both visual assessment and validation through more traditional fluorescence detection, and by the ability to use saliva-based sample collection to reduce equipment and cost needs.
• Validating the test in real-world contexts through studies with medical labs that have worked with qPCR for comparison. The project found that LAMP-based methods are almost as sensitive as PCR and are more reliable and feasible in the region.
• Achieving regulatory approval for LAMP detection of SARS-CoV-2 in several African countries, opening the door for LAMP-based detection of other viral diseases.
• Investing in research to enable local enzyme production and in workshops to introduce LAMP testing to labs within the EXPANDIA network.

Safeguarding advancements

All regions need access to public health infrastructure and effective molecular technology. As funding is sharply decreasing, lower resource countries need to reassess their healthcare and funding approaches to sustain initiatives. This includes partnering across sectors and regions to ensure sustainable and reliable health technology use.

Currently, EXPANDIA is aiming to improve regional resilience against multiple pathogens and collaborating with the sequencing of arboviruses to gather data for long-term prevention and treatment.

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