{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T18:20:36Z","timestamp":1778523636874,"version":"3.51.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013683","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["98684 BU RPA TMA 2015 CDF-979"],"award-info":[{"award-number":["98684 BU RPA TMA 2015 CDF-979"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>\n                    Molecular diagnostics are the gold standard laboratory confirmation test for Buruli ulcer (BU), a severe necrotising skin disease caused by\n                    <jats:italic>Mycobacterium ulcerans (M. ulcerans)<\/jats:italic>\n                    . However, current molecular tests are often performed outside endemic areas, which results in delayed diagnosis and increased patient management costs. To overcome these challenges and facilitate rapid diagnosis of clinically suspected BU lesions in affected communities, we developed a portable laboratory platform contained in two Pelican cases (each measuring 56 cm\u2009\u00d7\u200945.5 cm\u2009\u00d7\u200926.5 cm). We evaluated the feasibility of performing our earlier developed\n                    <jats:italic>M. ulcerans<\/jats:italic>\n                    Recombinase Polymerase Amplification (Mu-RPA) assay, along with a rapid DNA extraction method, using this mobile suitcase laboratory at BU clinics (BU-RPA mobile laboratory) in three endemic districts of Ghana. In the field, the entire process from sample collection to DNA extraction and amplification was completed in under one hour with this mobile setup. Among 39 PCR-confirmed BU cases, 32 (82%; 95% confidence interval [CI]: 67\u201391) were accurately identified by the BU-RPA mobile laboratory platform. All non-Buruli ulcer cases tested negative, resulting in a clinical specificity of 100% (95% CI: 90\u2013100). Diagnostic performance varied by sample type: swabs demonstrated a sensitivity of 91%, whereas fine-needle aspirates (FNA) had a sensitivity of 69%. This mobile laboratory platform provides an effective workspace for the rapid, on-site diagnosis of BU, enabling timely results for healthcare providers at treatment centres. This mobile suitcase laboratory, together with its isothermal assays, presents a promising alternative to PCR for the swift diagnosis of suspected BU cases as well as other neglected tropical diseases in resource-limited settings.\n                  <\/jats:p>","DOI":"10.1371\/journal.pntd.0013683","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:42:00Z","timestamp":1777916520000},"page":"e0013683","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Field deployment of a mobile suitcase laboratory for Buruli ulcer diagnosis in Ghana"],"prefix":"10.1371","volume":"20","author":[{"given":"Hubert Senanu","family":"Ahor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venus Nana","family":"Boakyewaa Frimpong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette","family":"Agbavor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kabiru Mohammed","family":"Abass","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Amofa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Ofori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Abd","family":"El Wahed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaw Ampem","family":"Amoako","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard Odame","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1901-6793","authenticated-orcid":true,"given":"Michael","family":"Frimpong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"pntd.0013683.ref001","doi-asserted-by":"crossref","first-page":"100490","DOI":"10.1016\/j.jctube.2024.100490","article-title":"Buruli ulcer: Current landscape, challenges, and future directions","volume":"38","author":"RR Yotsu","year":"2024","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"issue":"10327","key":"pntd.0013683.ref002","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/S0140-6736(22)00157-X","article-title":"Picturing health: Buruli ulcer in Ghana","volume":"399","author":"A Kumar","year":"2022","journal-title":"Lancet"},{"key":"pntd.0013683.ref003","doi-asserted-by":"crossref","first-page":"73","DOI":"10.2147\/CWCMR.S85469","article-title":"Buruli ulcer: wound care and rehabilitation","volume":"3","author":"R Phillips","year":"2016","journal-title":"CWCMR"},{"key":"pntd.0013683.ref004","doi-asserted-by":"crossref","first-page":"5310718","DOI":"10.1155\/2016\/5310718","article-title":"Clinical and laboratory diagnosis of Buruli ulcer disease: a systematic review","volume":"2016","author":"SA Sakyi","year":"2016","journal-title":"Can J Infect Dis Med Microbiol"},{"issue":"02","key":"pntd.0013683.ref005","doi-asserted-by":"crossref","DOI":"10.4172\/2329-891X.1000158","article-title":"Microscopy for Acid Fast Bacilli: A Useful but Neglected Tool in Routine Laboratory Diagnosis of Buruli Ulcer","volume":"03","author":"FM Sarpong","year":"2015","journal-title":"J Trop Dis"},{"issue":"2","key":"pntd.0013683.ref006","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007155","article-title":"Rapid detection of Mycobacterium ulcerans with isothermal recombinase polymerase amplification assay","volume":"13","author":"M Frimpong","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0013683.ref007","doi-asserted-by":"crossref","first-page":"204","DOI":"10.3390\/diagnostics9040204","article-title":"Rapid Extraction Method of Mycobacterium ulcerans DNA from Clinical Samples of Suspected Buruli Ulcer Patients","volume":"9","author":"M Frimpong","year":"2019","journal-title":"Diagnostics (Basel)"},{"key":"pntd.0013683.ref008","volume-title":"Report of a WHO\u2013FIND meeting on diagnostics for Buruli ulcer","author":"WHO","year":"2018"},{"issue":"11","key":"pntd.0013683.ref009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0010908","article-title":"A combined effort of 11 laboratories in the WHO African region to improve quality of Buruli ulcer PCR diagnosis: The \u201cBU-LABNET\u201d","volume":"16","author":"E Marion","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"issue":"10","key":"pntd.0013683.ref010","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1093\/infdis\/jiy362","article-title":"Development of Mobile Laboratory for Viral Hemorrhagic Fever Detection in Africa","volume":"218","author":"M Weidmann","year":"2018","journal-title":"J Infect Dis"},{"issue":"1","key":"pntd.0013683.ref011","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/s13071-016-1572-8","article-title":"Mobile suitcase laboratory for rapid detection of Leishmania donovani using recombinase polymerase amplification assay","volume":"9","author":"D Mondal","year":"2016","journal-title":"Parasit Vectors"},{"key":"pntd.0013683.ref012","article-title":"Clinical epidemiology of Buruli ulcer disease in Ghana, 2006-2024","author":"YA Amoako","year":"2025","journal-title":"Clin Exp Dermatol"},{"key":"pntd.0013683.ref013","volume-title":"Laboratory diagnosis of Buruli ulcer: a manual for health care providers","author":"F Portaels","year":"2014"},{"issue":"7","key":"pntd.0013683.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005695","article-title":"Clearance of viable Mycobacterium ulcerans from Buruli ulcer lesions during antibiotic treatment as determined by combined 16S rRNA reverse transcriptase \/IS 2404 qPCR assay","volume":"11","author":"M Sarpong-Duah","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"8","key":"pntd.0013683.ref015","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0001756","article-title":"Detection of viable Mycobacterium ulcerans in clinical samples by a novel combined 16S rRNA reverse transcriptase\/IS2404 real-time qPCR assay","volume":"6","author":"M Beissner","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013683.ref016","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jbi.2014.02.013","article-title":"Sample size estimation in diagnostic test studies of biomedical informatics","volume":"48","author":"K Hajian-Tilaki","year":"2014","journal-title":"J Biomed Inform"},{"issue":"2","key":"pntd.0013683.ref017","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1093\/trstmh\/traa118","article-title":"Diagnostics and the neglected tropical diseases roadmap: setting the agenda for 2030","volume":"115","author":"AA Souza","year":"2021","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"6","key":"pntd.0013683.ref018","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0129682","article-title":"Recombinase Polymerase Amplification Assay for Rapid Diagnostics of Dengue Infection","volume":"10","author":"A Abd El Wahed","year":"2015","journal-title":"PLoS One"},{"issue":"1","key":"pntd.0013683.ref019","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1186\/s13071-018-3238-1","article-title":"Evaluation of rapid extraction and isothermal amplification techniques for the detection of Leishmania donovani DNA from skin lesions of suspected cases at the point of need in Sri Lanka","volume":"11","author":"G Gunaratna","year":"2018","journal-title":"Parasit Vectors"},{"issue":"5","key":"pntd.0013683.ref020","article-title":"Detection of Mycobacterium ulcerans with IS2404 loop-mediated isothermal amplification and a fluorescent reporter probe","volume":"91","author":"JYH Lee","year":"2025","journal-title":"Appl Environ Microbiol"},{"issue":"11","key":"pntd.0013683.ref021","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004219","article-title":"Loop-Mediated Isothermal Amplification for Laboratory Confirmation of Buruli Ulcer Disease-Towards a Point-of-Care Test","volume":"9","author":"M Beissner","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013683.ref022","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1186\/s12879-021-06308-z","article-title":"Evaluation of different DNA extraction methods and loop-mediated isothermal amplification primers for the detection of Mycobacterium ulcerans in clinical specimens","volume":"21","author":"A Ablordey","year":"2021","journal-title":"BMC Infect Dis"},{"issue":"11","key":"pntd.0013683.ref023","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004247","article-title":"Simple, Rapid Mycobacterium ulcerans Disease Diagnosis from Clinical Samples by Fluorescence of Mycolactone on Thin Layer Chromatography","volume":"9","author":"A Wadagni","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"8","key":"pntd.0013683.ref024","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0270235","article-title":"Evaluation of the fluorescent-thin layer chromatography (f-TLC) for the diagnosis of Buruli ulcer disease in Ghana","volume":"17","author":"RK Amewu","year":"2022","journal-title":"PLoS One"},{"issue":"3","key":"pntd.0013683.ref025","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2217\/fmb.10.3","article-title":"Laboratory diagnosis of Buruli ulcer disease","volume":"5","author":"M Beissner","year":"2010","journal-title":"Future Microbiol"},{"key":"pntd.0013683.ref026","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.abst.2025.01.001","article-title":"Bringing lab to the field: Exploring innovations in point-of-care diagnostics for the rapid detection and management of tropical diseases in resource-limited settings","volume":"7","author":"AT Aborode","year":"2025","journal-title":"Advances in Biomarker Sciences and Technology"},{"issue":"44","key":"pntd.0013683.ref027","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2015.20.44.30053","article-title":"Development and deployment of a rapid recombinase polymerase amplification Ebola virus detection assay in Guinea in 2015","volume":"20","author":"O Faye","year":"2015","journal-title":"Euro Surveill"},{"issue":"5","key":"pntd.0013683.ref028","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011373","article-title":"Multi-centric evaluation of Biomeme Franklin Mobile qPCR for rapid detection of Mycobacterium ulcerans in clinical specimens","volume":"17","author":"M Frimpong","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013683.ref029","doi-asserted-by":"crossref","first-page":"107831","DOI":"10.1016\/j.ijid.2025.107831","article-title":"Recombinase polymerase amplification technology for point-of-care diagnosis of neglected tropical diseases","volume":"153","author":"L Hueso","year":"2025","journal-title":"Int J Infect Dis"},{"issue":"4","key":"pntd.0013683.ref030","first-page":"157","article-title":"Multiplex Recombinase Polymerase Amplification Assay for Simultaneous Detection of Treponema pallidum and Haemophilus ducreyi in Yaws-Like Lesions","volume":"5","author":"M Frimpong","year":"2020","journal-title":"Trop Med Infect Dis"},{"key":"pntd.0013683.ref031","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4314\/gmj.v54i4s.11","article-title":"Diagnostics for COVID-19: A case for field-deployable, rapid molecular tests for community surveillance","volume":"54","author":"M Frimpong","year":"2020","journal-title":"Ghana Med J"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013683","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013683","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:53:14Z","timestamp":1778521994000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013683"}},"subtitle":[],"editor":[{"given":"Anil","family":"Fastenau","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013683","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]}}}