Implementation of an effective and targeted mass drug administration program against filarial worms needs an accurate identification and mapping of the distribution of these parasites. Molecular diagnostic methods like polymerase chain reaction (PCR) based techniques have shown high sensitivity to detect and distinguish parasites at low infection levels and even in people that are amicrofilaremic by microscopy. However, larger scale implementation over time remains a challenge for low-income countries because of logistical complexity and costs, including collection, transportation and preservation of biological samples and running of the analytical tests.
In this study, we aimed to develop and implement a novel molecular based diagnostic approach for monitoring highly neglected filariasis causing parasites in Equatorial Guinea, West Africa. The ENAR protocol is an approach based on the use of nucleic acids (NA) extracted from dried blood retained on used malaria rapid diagnostic test (mRDT). Malaria RDTs used in this work were stored at room temperature for around 18 months before used for molecular analysis and served as reliable source for NA based detection of blood-dwellings pathogens beyond malaria. Our approach of repurposing used mRDTs for filarial parasites detection provides a versatile and cost-effective approach to monitor prevalence, genotype, infection intensity and co-infections of filarial nematodes and other blood borne infectious diseases.