Two-stage sample-to-answer system based on nucleic acid amplification approach for detection of malaria parasites

• A two-stage sample-to-answer system capable of detecting malaria parasite.
• Rapid, highly sensitive, accurate, and cost-effective system.
• First combination system of a disposable extraction chip and a real-time sensor.
• The system would be of great potential for better diagnosis of malaria in real-setting.

Rapid, early, and accurate diagnosis of malaria is essential for effective disease management and surveillance, and can reduce morbidity and mortality associated with the disease. Although significant advances have been achieved for the diagnosis of malaria, these technologies are still far from ideal, being time consuming, complex and poorly sensitive as well as requiring separate assays for sample processing and detection. Therefore, the development of a fast and sensitive method that can integrate sample processing with detection of malarial infection is desirable. Here, we report a two-stage sample-to-answer system based on nucleic acid amplification approach for detection of malaria parasites. It combines the Dimethyl adipimidate (DMA)/Thin film Sample processing (DTS) technique as a first stage and the Mach-Zehnder Interferometer-Isothermal solid-phase DNA Amplification (MZI-IDA) sensing technique as a second stage. The system can extract DNA from malarial parasites using DTS technique in a closed system, not only reducing sample loss and contamination, but also facilitating the multiplexed malarial DNA detection using the fast and accurate MZI-IDA technique. Here, we demonstrated that this system can deliver results within 60 min (including sample processing, amplification and detection) with high sensitivity (<1 parasite μL−1) in a label-free and real-time manner. The developed system would be of great potential for better diagnosis of malaria in low-resource settings.