Women in sub-Saharan Africa face complex, multifaceted challenges to their health, including a high burden of infectious diseases aggravated by socioeconomic factors. Parasitic and sexually transmitted infections both cause significant morbidity and mortality. Co-infections compound these effects, leading to high rates of chronic illness and making diagnosis and treatment challenging. There are no integrated approaches for the detection of female genital schistosomiasis (FGS), a gynaecological condition caused by Schistosoma haematobium, and high-risk human papillomavirus (HR-HPV), responsible for over 90% of all cervical cancer cases worldwide. FGS is a chronic condition with health outcomes such as infertility and abortion and remains severely under-reported. HR-HPV infection is the main aetiological agent of cervical cancer, the leading cause of cancer death in women in sub-Saharan Africa. Both can be disabling and stigmatizing to the sufferer. A key to disease management at patient and community levels is accurate and available diagnostics. Due to both FGS and HPV diagnostics utilising cervicovaginal samples, they are ideal candidates for a multiplex molecular diagnostic. The standard molecular diagnostics (namely PCR), through the detection of pathogen DNA, are constrained in low resource settings by requirement of a highly reliable source of energy, reliance on a cold-chain, and prohibitive costs. Isothermal molecular diagnostics are an alternative method to PCR that are more suited to basic settings. This review explores current isothermal diagnostics, with a focus on RPA/RAA, a very simple isothermal technology, for FGS and HPV and proposes the development of a multiplex isothermal diagnostic test to enable integrated screening.

Blastocystis sp. is a common parasite in the intestinal tract of humans and animals. The clinical diagnosis of Blastocystis sp. mainly depends on the microscopic observation of parasite, which can lead to false-negative results. An accurate and convenient diagnostic approach for Blastocystis sp. infection is crucial for effectively preventing and controlling blastocystosis. Herein, we developed a recombinase polymerase amplification (RPA) method for detecting Blastocystis sp. The results showed that the DNA amplification by RPA established in this study could be performed within 5 min at 37°C, with maximum band intensity observed at 30 min. The minimum detection limit of RPA was 100 fg μL−1, consistent with conventional polymerase chain reaction (cPCR). Furthermore, the RPA method exhibited no cross-reactivity with 7 other non-target pathogens in the intestinal tract. Next, the newly established RPA method was used to analyse 40 fecal samples collected clinically, and the detection results were consistent with cPCR. These results corroborate that the newly developed RPA method has good sensitivity and specificity and offers the advantage of short detection times, which can be harnessed for differential diagnosis and rapid detection of Blastocystis sp.