Advancing Chikungunya Diagnosis: A Cost-Effective and Rapid Visual employing Loop-mediated isothermal reaction

Arboviruses, diseases transmitted by arthropods infected with arbovirus, have a profound impact on public health, affecting a staggering number of individuals worldwide [1,2]. Chikungunya is an infection caused by the Chikungunya virus (CHIKV), which is transmitted by mosquitoes such as Aedes aegypti and Aedes albopictus [3]. Due to the significant increase in cases and the potential to spread to several countries, CHIKV is among the priority pathogens in the WHO Blueprint, a global strategic plan developed by the World Health Organization. Although chikungunya is not highly lethal, it has an epidemic nature and a high rate of morbidity associated with musculoskeletal disorders [4], arthralgia, and persistent arthritis [5], as well as depression [6] and neurological complications such as optic neuropathy, encephalitis, neuroretinitis, and Guillain-Barré syndrome [7]. Consequently, it leads to reduced productivity and a lower quality of life for the individuals [8].

The clinical manifestations of chikungunya are similar to other exanthematic febrile diseases such as dengue and zika, characterized by fever, joint and muscle pain, fatigue, headache, nausea, and rash [9]. Thus, the diagnostic distinction between these diseases is important to ensure appropriate treatment and adequate clinical management. In addition, as there are still no vaccines and drugs that help prevent and treat the virus, epidemiological monitoring is a necessity and must be prioritized, as it allows understanding of the current scenario of arboviruses that can guide decision-making, implementation of vector control measures to prevent the spread of disease and target resources more efficiently.

The laboratory diagnosis of CHIKV can be conducted indirectly by searching for specific antibodies or directly through viral isolation and detection of viral RNA in various clinical samples. The gold standard method is RT-qPCR (Reverse Transcription followed by Quantitative Polymerase Chain Reaction), which amplifies and detects the virus's genetic material [10]. Despite the recognized importance of this technique, popularizing CHIKV diagnosis remains a challenge. RT-qPCR is costly and time-consuming. Therefore, there is a current need for alternative techniques that are rapid, cost-effective, easy to implement, and reliable for molecular diagnosis. These techniques can assist in epidemiological monitoring and community surveillance, serving as valuable tools for the rapid screening of populations, facilitating prompt and accurate treatment of these infections, and guiding public health interventions.

The RT-LAMP (Reverse Transcriptase Loop-Mediated Isothermal Amplification) technique has gained recognition in recent years for its application in detecting various pathogens. The technique involves amplifying genetic material at a constant temperature [11]. The isothermal reaction eliminates the need for expensive thermal cyclers, as a heating block or water bath can be used instead. Depending on the method employed, the results can be visually observed, eliminating the requirement for specialized labor to interpret the data. This characteristic reduces operational costs associated with the test. The simplicity of the technique enables its application in emergency care settings and resource-limited situations and locations [12].

Thus, the objective of this study was to standardize and validate a molecular diagnostic method for CHIKV based on the LAMP technique, aiming to provide a more accessible, rapid, and cost-effective alternative. By establishing a reliable protocol and evaluating its effectiveness using clinical samples, we aim to contribute to the enhancement of CHIKV diagnosis and surveillance, particularly in areas with limited access to laboratory resources.

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