Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis

Abstract Current nucleic acid amplification techniques for the diagnosis of pulmonary tuberculosis (TB) lack the simplicity and affordability of achieving the goals envisioned in the WHO END-TB strategy, particularly for low- and middle-income countries (LMICs). Here we report a cost-effective real-...

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Main Authors: Swathy S. Nair, Ria Elza Varghese, Anjana Saji, Anoopkumar Thekkuveettil
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-93565-6
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author Swathy S. Nair
Ria Elza Varghese
Anjana Saji
Anoopkumar Thekkuveettil
author_facet Swathy S. Nair
Ria Elza Varghese
Anjana Saji
Anoopkumar Thekkuveettil
author_sort Swathy S. Nair
collection DOAJ
description Abstract Current nucleic acid amplification techniques for the diagnosis of pulmonary tuberculosis (TB) lack the simplicity and affordability of achieving the goals envisioned in the WHO END-TB strategy, particularly for low- and middle-income countries (LMICs). Here we report a cost-effective real-time LAMP (rt-LAMP) assay with high sensitivity for the early diagnosis of pulmonary TB. A sample size of 350 was calculated using Buderer’s formula. The assay was validated in the laboratory using mpt64 cloned gene targets and clinical patient samples. The lower limit of detection for the rt-LAMP assay was observed as 10 copies/µl. Out of 350 suspected TB patient samples, 47 were positive for MGIT culture (microbiological reference standard, MRS), 42 were positive for Xpert MTB/RIF and 41 were positive for rt-LAMP assay. Compared to MRS, rt-LAMP showed a sensitivity of 89.36% (95% CI 76.9–96.45%) and a specificity of 94.06% (95% CI 90.77–96.44%). When compared to Xpert MTB/RIF, rt-LAMP showed a sensitivity of 93.33% (95% CI 83.80–98.15%), a specificity of 98.62% (95% CI 96.51–99.62%), negative predictive value of 98.62% (95% CI 96.52–99.47%), positive predictive value of 93.33% (95% CI 84.07–97.38%). Youden index value of rt-LAMP was 0.92 when compared with Xpert MTB/RIF, indicating a significantly low false positive rate. As the technology has been developed in an open platform, the assay will be useful in early diagnosis of pulmonary TB, particularly in screening large susceptible populations in LMICs.
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spelling doaj-art-efa00dadca804e9b918ba72c080919f42025-08-20T03:40:50ZengNature PortfolioScientific Reports2045-23222025-03-011511810.1038/s41598-025-93565-6Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosisSwathy S. Nair0Ria Elza Varghese1Anjana Saji2Anoopkumar Thekkuveettil3Division of Molecular Medicine, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyDivision of Molecular Medicine, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyDivision of Molecular Medicine, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyDivision of Molecular Medicine, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyAbstract Current nucleic acid amplification techniques for the diagnosis of pulmonary tuberculosis (TB) lack the simplicity and affordability of achieving the goals envisioned in the WHO END-TB strategy, particularly for low- and middle-income countries (LMICs). Here we report a cost-effective real-time LAMP (rt-LAMP) assay with high sensitivity for the early diagnosis of pulmonary TB. A sample size of 350 was calculated using Buderer’s formula. The assay was validated in the laboratory using mpt64 cloned gene targets and clinical patient samples. The lower limit of detection for the rt-LAMP assay was observed as 10 copies/µl. Out of 350 suspected TB patient samples, 47 were positive for MGIT culture (microbiological reference standard, MRS), 42 were positive for Xpert MTB/RIF and 41 were positive for rt-LAMP assay. Compared to MRS, rt-LAMP showed a sensitivity of 89.36% (95% CI 76.9–96.45%) and a specificity of 94.06% (95% CI 90.77–96.44%). When compared to Xpert MTB/RIF, rt-LAMP showed a sensitivity of 93.33% (95% CI 83.80–98.15%), a specificity of 98.62% (95% CI 96.51–99.62%), negative predictive value of 98.62% (95% CI 96.52–99.47%), positive predictive value of 93.33% (95% CI 84.07–97.38%). Youden index value of rt-LAMP was 0.92 when compared with Xpert MTB/RIF, indicating a significantly low false positive rate. As the technology has been developed in an open platform, the assay will be useful in early diagnosis of pulmonary TB, particularly in screening large susceptible populations in LMICs.https://doi.org/10.1038/s41598-025-93565-6
spellingShingle Swathy S. Nair
Ria Elza Varghese
Anjana Saji
Anoopkumar Thekkuveettil
Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis
Scientific Reports
title Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis
title_full Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis
title_fullStr Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis
title_full_unstemmed Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis
title_short Validation study of a novel, rapid, open platform real-time LAMP assay for early diagnosis of pulmonary tuberculosis
title_sort validation study of a novel rapid open platform real time lamp assay for early diagnosis of pulmonary tuberculosis
url https://doi.org/10.1038/s41598-025-93565-6
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