Table 1.
List of equipment, materials/consumable and reagents in the mobile suitcase laboratory.
Fig 1.
BU-RPA mobile suitcase laboratory development and deployment in the field.
(A) The fully assembled mobile suitcase laboratory comprises two Pelican cases (ZARGES GmbH, Weilheim, Germany), each measuring 56 cm × 45.5 cm × 26.5 cm and equipped with a power pack. The left suitcase is designed for DNA extraction, while the right suitcase is dedicated to DNA amplification. (B) Field deployment of the BU-RPA mobile laboratory platform. The suitcase laboratories, along with the power pack and essential reagents including RPA kits, primers, and probes are routinely transported to BU clinics. (C) Field setup of the mobile suitcase laboratory at the BU clinics.
Fig 2.
Map of Ghana showing the study sites.
The map was generated using QGIS version 3.34 LTR (Prizren). Base map data OpenStreetMap contributors, licensed under the Open Database License (ODbL) (https://www.openstreetmap.org).
Fig 3.
Workflow of the BU-RPA mobile laboratory platform.
(1) Clinical screening and collect samples of swabs from ulcerative lesions and fine needle aspirates (FNA) from non-ulcerative lesions. Elute samples in GenoLyse lysis buffer and transfer them immediately to the mobile laboratory. (2) Perform rapid DNA extraction in the extraction suitcase using a modified GenoLyse protocol that includes an extraction control. (3) Set up the RPA reaction and conduct isothermal amplification targeting IS2404 in the amplification suitcase, incorporating positive and non-template controls. Use the Axxin T8-ISO fluorometer for real-time fluorescence detection and interpret the results on-site. Compare BU-RPA results with laboratory-based IS2404 qPCR for performance evaluation.
Table 2.
Demographic and clinical characteristics of suspected BU cases.
Fig 4.
Turn around time of the BU-RPA mobile laboratory platform.
The turnaround time for diagnosing clinically suspected BU lesions using the BU-RPA mobile laboratory platform, stratified by sample type (A) and lesion type (B). Mann-Whitney and Kruskal-Wallis tests were employed to compare the turnaround time in diagnosing types of samples (FNA (n = 29) and swab (n = 44) and types of lesions (ulcer (n = 44), plaque (n = 17), nodule (n = 10), edema (n = 2)) respectively, with a p-value of less than 0.05 considered statistically significant.
Table 3.
Clinical sensitivity and specificity of the BU-RPA mobile laboratory platform compared to qPCR (stratified by characteristic of BU lesions and sample type).