{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:23:04Z","timestamp":1792513384825,"version":"4.5.0"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia Tecnolog\u00eda e Innovaci\u00f3n","doi-asserted-by":"crossref","award":["222972553501"],"award-info":[{"award-number":["222972553501"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Center for Tropical Diseases, University of Texas Medical Branch"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Control of cutaneous leishmaniasis by public health systems in the Americas relies on case identification and treatment. Point-of-care diagnostics that can be performed by health workers within or near affected communities could effectively bring the health system to the resource-limited sites providing early diagnosis and treatment, reducing morbidity and the burden of disease.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/principal findings<\/jats:title>\n<jats:p>A cross-sectional study was undertaken to evaluate the diagnostic test performance of Isothermal Recombinase Polymerase Amplification (RPA) targeting <jats:italic>Leishmania<\/jats:italic> kinetoplast DNA, coupled with a lateral flow (LF) immunochromatographic strip, in a field setting and a laboratory reference center. Minimally invasive swab and FTA filter paper samples were obtained by community health workers and highly trained technicians from ulcerated lesions of &gt; 2 weeks\u2019 evolution from 118 patients\u2019 \u2265 2 years of age in the municipality of Tumaco, Nari\u00f1o. Extracted DNA was processed by RPA-LF at a reference center or in a primary health facility in the field. Evaluation was based on a composite \u201cgold standard\u201d that included microscopy, culture, biopsy and real-time polymerase chain reaction detection of <jats:italic>Leishmania<\/jats:italic> 18S rDNA. Standard of care routine diagnostic tests were explored as comparators.<\/jats:p>\n<jats:p>Sensitivity and specificity of RPA-LF in the reference lab scenario were 87% (95%CI 74\u201394) and 86% (95%CI 74\u201397), respectively. In the field scenario, the sensitivity was 75% (95%CI 65\u201384) and specificity 89% (95%CI 78\u201399). Positive likelihood ratios in both scenarios were higher than 6 while negative likelihood ratios ranged to 0.2\u20130.3 supporting the usefulness of RPA-LF to rule-in and potentially to rule-out infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/significance<\/jats:title>\n<jats:p>The low complexity requirements of RPA-LF combined with non-invasive sampling support the feasibility of its utilization by community health workers with the goal of strengthening the diagnostic capacity for cutaneous leishmaniasis in Colombia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>ClinicalTrials.gov <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04500873\" xlink:type=\"simple\">NCT04500873<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0009291","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T17:58:02Z","timestamp":1619632682000},"page":"e0009291","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnostic performance of a Recombinant Polymerase Amplification Test\u2014Lateral Flow (RPA-LF) for cutaneous leishmaniasis in an endemic setting of Colombia"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2247-5459","authenticated-orcid":true,"given":"Alexandra","family":"Cossio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimena","family":"Jojoa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0485-2919","authenticated-orcid":true,"given":"Mar\u00eda del Mar","family":"Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth Mabel","family":"Castillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5121-4741","authenticated-orcid":true,"given":"Lyda","family":"Osorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6686-6032","authenticated-orcid":true,"given":"Thomas R.","family":"Shelite","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Gore Saravia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Melby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4160-302X","authenticated-orcid":true,"given":"Bruno L.","family":"Travi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"pntd.0009291.ref001","unstructured":"PAHO. 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[cited 4 May 2020] p. 3. http:\/\/www.ins.gov.co\/buscador-eventos\/BoletinEpidemiologico\/2019_Boletin_epidemiologico_semana_41.pdf","DOI":"10.33610\/23576189.2019.41"},{"key":"pntd.0009291.ref005","unstructured":"PAHO. Plan of action to strengthen the surveillance and control of leishmaniasis in the Americas 2017\u20132022. 2017. https:\/\/iris.paho.org\/handle\/10665.2\/34147"},{"key":"pntd.0009291.ref006","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0061843","article-title":"Interventions for American Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review Update","volume":"8","author":"L Reveiz","year":"2013","journal-title":"PLoS One"},{"key":"pntd.0009291.ref007","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1590\/abd1806-4841.20142389","article-title":"Complementary exams in the diagnosis of American tegumentary leishmaniasis","volume":"89","author":"CM Gomes","year":"2014","journal-title":"An Bras Dermatol"},{"key":"pntd.0009291.ref008","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4269\/ajtmh.1987.36.489","article-title":"Diagnosis of Cutaneous and Mucocutaneous Leishmaniasis in Colombia: A Comparison of Seven Methods","volume":"36","author":"KA 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Guideline on health policy and system support to optimize community health worker programmes. 2018."},{"key":"pntd.0009291.ref027","doi-asserted-by":"crossref","DOI":"10.1080\/16549716.2017.1272223","article-title":"Who is a community health worker?\u2014A systematic review of definitions","volume":"10","author":"A Olaniran","year":"2017","journal-title":"Glob Health Action"},{"key":"pntd.0009291.ref028","unstructured":"FDA. Guidance for Industry and FDA Staff Statistical Guidance on Reporting Results from Studies Evaluating Diagnostic Tests. In: FDA [Internet]. 2007 pp. 1\u201339. http:\/\/www.fda.gov\/MedicalDevices\/DeviceRegulationandGuidance\/GuidanceDocuments\/ucm071148.htm"},{"key":"pntd.0009291.ref029","doi-asserted-by":"crossref","first-page":"738","DOI":"10.4269\/ajtmh.2002.66.738","article-title":"Heterogeneity, geographic distribution, and pathogenicity of serodemes of Leishmania Viannia in Colombia","volume":"66","author":"NG Saravia","year":"2002","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0009291.ref030","doi-asserted-by":"crossref","unstructured":"Saravia NG, Segura I, Holguin AF, Santrich C, Valderrama L, Ocampo C. Epidemiologic, genetic, and clinical associations among phenotypically distinct populations of Leishmania (viannia) in Colombia. Am J Trop Med Hyg. 1998.","DOI":"10.4269\/ajtmh.1998.59.86"},{"key":"pntd.0009291.ref031","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1038\/291581a0","article-title":"Monoclonal antibodies that distinguish between New World species of Leishmania","volume":"291","author":"D McMahon Pratt","year":"1981","journal-title":"Nature"},{"key":"pntd.0009291.ref032","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.4269\/ajtmh.19-0691","article-title":"Comparative assessment of dna targets and amplification methods for leishmania (Viannia) detection in human samples","volume":"102","author":"M Rosales-Chilama","year":"2020","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0009291.ref033","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1128\/JCM.01416-07","article-title":"Comparison between quantitative nucleic acid sequence-based amplification, real-time reverse transcriptase PCR, and real-time PCR for quantification of Leishmania parasites","volume":"46","author":"W Van Der Meide","year":"2008","journal-title":"J Clin Microbiol"},{"key":"pntd.0009291.ref034","unstructured":"Gordis L. Epidemiology. Fifth Ed. 2014. pp. 88\u2013115."},{"key":"pntd.0009291.ref035","volume-title":"R: A language and environment for statistical computing","author":"R Core Team"},{"key":"pntd.0009291.ref036","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/BF02295996","article-title":"Note on the sampling error of the difference between correlated proportions or percentages","volume":"12","author":"Q McNemar","year":"1947","journal-title":"Psychometrika"},{"key":"pntd.0009291.ref037","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1093\/biostatistics\/kxn025","article-title":"Estimating the capacity for improvement in risk prediction with a marker","volume":"10","author":"W Gu","year":"2009","journal-title":"Biostatistics"},{"key":"pntd.0009291.ref038","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12936-018-2358-6","article-title":"Evaluation of malaria rapid diagnostic test (RDT) use by community health workers: A longitudinal study in western Kenya","volume":"17","author":"MR Boyce","year":"2018","journal-title":"Malar J"},{"key":"pntd.0009291.ref039","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12936-017-2005-7","article-title":"Malaria case management by community health workers in the Central African Republic from 2009\u20132014: Overcoming challenges of access and instability due to conflict","volume":"16","author":"L Ruckstuhl","year":"2017","journal-title":"Malar J"},{"key":"pntd.0009291.ref040","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2334-12-191","article-title":"Polymorphism-specific PCR enhances the diagnostic performance of American tegumentary leishmaniasis and allows the rapid identification of Leishmania species from Argentina","volume":"12","author":"JD Marco","year":"2012","journal-title":"BMC Infect Dis"},{"key":"pntd.0009291.ref041","unstructured":"Melo SN De, Pereira DA, Fontes IDC, Morselli I. Accuracy of diagnostic tests for American Tegumentary Leishmaniasis: a systematic literature review with meta-analyses."},{"key":"pntd.0009291.ref042","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1111\/tmi.13465","article-title":"Accuracy of diagnostic tests for American tegumentary leishmaniasis: a systematic literature review with meta-analyses","volume":"25","author":"HP Pena","year":"2020","journal-title":"Trop Med Int Heal"},{"key":"pntd.0009291.ref043","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1086\/648730","article-title":"Detection and species identification of Leishmania DNA from filter paper lesion impressions for patients with american cutaneous leishmaniasis","volume":"50","author":"AK Boggild","year":"2010","journal-title":"Clin Infect Dis"},{"key":"pntd.0009291.ref044","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1371\/journal.pone.0049738","article-title":"Non-Invasive Cytology Brush PCR for the Diagnosis and Causative Species 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