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Diagnostics of Ebola virus.

Aurora Bettini1, Daniele Lapa1, Anna Rosa Garbuglia1

  • 1Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani (IRCCS), Rome, Italy.

Frontiers in Public Health
|March 13, 2023
PubMed
Summary

Rapid Ebola virus detection is crucial. Current molecular tests offer accuracy but delays, while rapid diagnostic tests (RDTs) lack sufficient sensitivity, necessitating confirmation with molecular assays for suspected cases.

Keywords:
Eboladiagnosticsmolecular testoutbreakrapid diagnostic test (RDT)real-time

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Area of Science:

  • Virology
  • Infectious Diseases
  • Diagnostic Technologies

Background:

  • Ebola virus poses a significant public health threat with high mortality rates.
  • Decentralized diagnostic capabilities are limited in endemic regions, leading to sample shipment and delayed results.
  • Timely diagnosis is critical for patient isolation and effective community-level interventions.

Purpose of the Study:

  • To review current diagnostic methods for Ebola virus disease.
  • To evaluate the sensitivity and feasibility of different diagnostic platforms.
  • To inform the development and application of effective Ebola diagnostic strategies.

Main Methods:

  • Analysis of molecular diagnostic assays, including Real-Star Altona and Cepheid systems.
  • Assessment of isothermal amplification methods like LAMP (Loop-mediated Isothermal Amplification).
  • Review of rapid diagnostic tests (RDTs) utilizing immunochromatographic methods to detect anti-Ebola antibodies.

Main Results:

  • Molecular assays like Real-Star Altona and Cepheid demonstrate good sensitivity, with varying detection limits for different Ebola virus strains.
  • Loop-mediated Isothermal Amplification (LAMP) shows high analytical sensitivity (1 copy/reaction) but requires further real-world validation.
  • Current RDTs targeting viral proteins (VP40, NP, GP) exhibit variable sensitivities (53-93.1%), generally below the WHO's recommended 99% threshold.

Conclusions:

  • No current rapid diagnostic tests (RDTs) meet the WHO's 99% sensitivity recommendation for Ebola virus detection.
  • Molecular tests remain the gold standard but are limited by logistical challenges in endemic areas.
  • Negative RDT results in suspected Ebola cases require confirmation via molecular testing to ensure accurate diagnosis and management.