Diagnostics for Lassa fever virus: a genetically diverse pathogen found in low-resource settings

Area of Science:

• Medical Virology
• Infectious Diseases
• Public Health

Background:

• Lassa fever virus (LASV) causes severe hemorrhagic fever, endemic to West Africa.
• LASV is a high-priority pathogen due to its high fatality rate and transmission via rodents.
• Effective diagnostics are essential for the WHO's Lassa fever vaccine strategy.

Purpose of the Study:

• To identify diagnostic gaps for Lassa fever virus (LASV).
• To highlight the need for improved diagnostic sensitivity, lineage detection, and point-of-care testing.
• To inform target product profiles for enhanced LASV diagnostics.

Main Methods:

• Review of current Lassa fever virus (LASV) diagnostic methods, including serological and nucleic acid amplification tests.
• Evaluation of commercially available rapid diagnostic tests (RDTs) and multiplex panels.
• Assessment of diagnostic challenges related to genomic diversity and sensitivity.

Main Results:

• Existing LASV diagnostics have limitations in pan-lineage sensitivity and variable PCR test performance.
• Commercial LASV tests are primarily for research use only, lacking external quality assessment.
• There is a need for more point-of-care testing options, especially for low-resource settings.

Conclusions:

• Improved validation and external quality assessment are critical for LASV molecular and immunological assays.
• Development of sensitive, pan-lineage diagnostic tools is necessary for surveillance and outbreak control.
• Future LASV diagnostic development should prioritize point-of-care capabilities and address genomic diversity.