{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T19:29:30Z","timestamp":1784575770721,"version":"3.55.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vector-Borne and Zoonotic Diseases"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>\n                    Cutaneous leishmaniasis (CL) is highly prevalent in rural and sylvatic regions of Latin America, with an estimated 55,000 annual cases. Diagnosis in resource-limited areas still relies on microscopy of dermal scrapings, while more sensitive methods like PCR are not attainable due to costs and lack of adequate health infrastructure. Isothermal amplification of\n                    <jats:italic toggle=\"yes\">Leishmania<\/jats:italic>\n                    DNA can be performed without sophisticated equipment and training and may become a point of care (POC) test for health care centers with scarce resources. We evaluated the efficacy of recombinase-polymerase-amplification (RPA-LF) to diagnose CL in 226 patients attending a clinic in Puerto Maldonado within the Peruvian Amazon basin. Conventional PCR targeting kinetoplast DNA (kDNA-PCR) was used as the gold standard. Eight of 226 patients were considered true negatives (microscopy, kDNA-PCR, and RPA-LF negative), while RPA-LF resulted positive in 186 of 204 kDNA-PCR positive patients, yielding 91.2% (confidence interval [CI]\u2009=\u200986.5\u201394.4%) sensitivity and 93% (CI 88.6\u201395.8%) positive predictive value. There were 14% (32\/226) discrepant samples alternating positive and negative results in similar proportions between both tests. Quantitative PCR used to resolve the discrepancies suggested that they occurred in samples with scarce parasite numbers as determined by high cycle threshold (Ct) values (\u226532; cutoff 35.5). Microscopy had the lowest sensitivity of all methods (45.4%). Nested real-time PCR performed in 71 samples determined that\n                    <jats:italic toggle=\"yes\">Leishmania<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">Viannia<\/jats:italic>\n                    )\n                    <jats:italic toggle=\"yes\">braziliensis<\/jats:italic>\n                    was highly prevalent (69\/71), and\n                    <jats:italic toggle=\"yes\">Leishmania<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">Viannia<\/jats:italic>\n                    )\n                    <jats:italic toggle=\"yes\">lainsoni<\/jats:italic>\n                    was present in only two isolates. Results indicated that RPA-LF has POC potential for CL endemic areas, yet further simplification and optimization coupled with field validation will be necessary to confirm its broad applicability.\n                  <\/jats:p>","DOI":"10.1089\/vbz.2021.0038","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T14:25:45Z","timestamp":1634653545000},"page":"941-947","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Diagnostic Efficacy of Recombinase-Polymerase-Amplification Coupled with Lateral Flow Strip Reading in Patients with Cutaneous Leishmaniasis from the Amazonas Rainforest of Per\u00fa"],"prefix":"10.1177","volume":"21","author":[{"given":"Bruno L.","family":"Travi","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA."},{"name":"Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxy B.","family":"Delos Santos","sequence":"additional","affiliation":[{"name":"Department of Parasitology, U.S. Naval Medical Research Unit 6 (NAMRU-6), Lima, Peru."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Shelite","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio P.","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Parasitology, U.S. Naval Medical Research Unit 6 (NAMRU-6), Lima, Peru."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis A.","family":"Rosales","sequence":"additional","affiliation":[{"name":"Department of Parasitology, U.S. Naval Medical Research Unit 6 (NAMRU-6), Lima, Peru."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Castellanos-Gonzalez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA."},{"name":"Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Saldarriaga","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Melby","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA."},{"name":"Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2006.07.001"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0035671"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(96)90112-1"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000313"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2010.09-0414"},{"key":"e_1_3_4_7_1","unstructured":"Bol-Epidemiol-Peru [Epidemiological Bulletin of Peru]. An\u00e1lisis y tendencia de la leishmaniosis en el Per\u00fa: situaci\u00f3n hasta agosto de 2012 [Analysis and tendency of leishmaniasis in Peru: situation up to August 2012]. Ministerio de salud [Ministry of Health] 2012."},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31204-2"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2018.02.002"},{"key":"e_1_3_4_10_1","unstructured":"CDC-Peru. Leishmaniosis [Peru CDC. Leishmaniasis]. Centro Nacional de Epidemiologia Prevencion y Control de Enfermedades [National Center of Epidemiology Prevention and Disease Control] Ministerio de Salud [Ministry of Health] 2019."},{"key":"e_1_3_4_11_1","first-page":"446","article-title":"Identification of Leishmania species in patients and phlebotomines in transmission areas in a region of Peru [in Spanish]","volume":"28","author":"Cordova O","year":"2011","unstructured":"Cordova O, , Vargas F, , Hashiguchi Y, , Kato H, et al. Identification of Leishmania species in patients and phlebotomines in transmission areas in a region of Peru [in Spanish]. Rev Peru Med Exp Salud Publica, 2011; 28:446\u2013453.","journal-title":"Rev Peru Med Exp Salud Publica"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parepi.2019.e00103"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-015-0114-z"},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02555-06"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-018-2859-8"},{"key":"e_1_3_4_16_1","first-page":"39","article-title":"Patients' associations and the control of leishmaniasis in Peru","volume":"75","author":"Guthmann JP","year":"1997","unstructured":"Guthmann JP, , Calmet J, , Rosales E, , Cruz M, et al. Patients' associations and the control of leishmaniasis in Peru. 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