Diagnostic accuracy of a single-reaction, pan-lineage Lassa virus RT-PCR at two Nigerian laboratories: a retrospective and prospective cohort study

PANDAA(R) single-reaction pan-lineage Lassa virus RT-PCR detected LASV RNA with 98.6% sensitivity (138/140) and 99.4% specificity (155/156) in Nigerian suspected-case plasma.

• Why it matters: Intra- and inter-lineage LASV diversity makes it hard to use one RT-PCR reaction without losing sensitivity, and Nigeria’s current standard uses two reactions to reduce false negatives.
• What they did: A diagnostic accuracy study tested retrospectively (n = 200) and prospectively (n = 100) collected plasma from suspected Lassa fever patients at two laboratories, comparing PANDAA(R) to RealStar(R) RT-PCR Kit 2.0 and assessing Ct correlations (Spearman’s rho = 0.80 and 0.69).
• The result: PANDAA(R) achieved 99.0% accuracy (293/296) with positive likelihood ratio 153.8 and negative likelihood ratio 0.01, showed consistent performance across sites, and had discordant high-Ct results near detection limits.

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