DUGi

Aplicació de la tècnica recombinase polymerase amplification (rpa) al diagnòstic de la malària: una revisió bibliogràfica

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Malaria is a disease that mainly affects the African continent. It is transmitted by mosquitoes of the genus Anopheles and caused by protozoa of the genus Plasmodium, responsible for approximately 597,000 deaths annually. The parasite has a life cycle with two different phases: a sexual phase in the vector, and an asexual phase in the vertebrate host. Symptoms can vary in severity and, if untreated, can be grave. Standard treatments include chloroquine and artemisinin derivatives. Diagnosis can be based on microscopic, immunological, or molecular techniques. For the latter, PCR stands out for its sensitivity, but requires expensive and sophisticated equipment, making it difficult to use in resource-limited settings (point-of-care, POC). For this reason, isothermal techniques such as LAMP have been developed, although this presents certain complexity in the reaction and the interpretation of results. A promising alternative is RPA (Recombinase Polymerase Amplification), a technique that is also isothermal but simpler and more suitable for diagnosis in field conditions. This study aims to analyse the functioning of RPA and evaluate its potential for malaria diagnosis. To this end, a literature review was conducted using Web of Science, Scopus, and PubMed databases, with combinations of the keywords "malaria," "Plasmodium," "RPA," and "Recombinase Polymerase Amplification." 15 relevant articles were selected based on their titles and abstracts. RPA allows the amplification of target DNA fragments without the need for temperature cycles, thanks to the action of the recombinase enzyme. This technique can differentiate among Plasmodium species, thus contributing to the administration of appropriate treatment. Furthermore, it can be combined with detection systems such as SYBR Green, lateral flow, CRISPR/Cas, or LAMP to facilitate the visualization of results. Despite some weaknesses, RPA shows great potential as a diagnostic tool in resourcelimited areas and for epidemiological surveillance systems. Its sensitivity, comparable to that of PCR, its high specificity, and the possibility of integrating it into portable devices make it a promising option for malaria control and elimination

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