Breaking Barriers in Skin NTD Diagnostics: Fast, Field-Ready Tools Meet Real-World Needs

A new wave of diagnostic tools is reshaping how skin-related neglected tropical diseases (NTDs) are detected and managed — combining rapid molecular assays with ultrafast, centrifuge-free DNA extraction. From Ghanaian clinics to North African field labs and German molecular benches, these innovations are proving one thing: diagnostic equity can be built into the tools themselves.
 

Introduction

Imagine walking into a rural clinic with a painful ulcer. The nurse suspects Buruli ulcer. Or maybe it’s cutaneous leishmaniasis. But there’s no test, no microscope — and no way to know for sure.

This is the diagnostic bottleneck for millions affected by skin NTDs. Diseases that scar skin and fracture trust in health systems. But now, that paradigm is starting to shift.

At Xpedite Diagnostics’ recent webinar, Breaking Barriers in Skin NTD Diagnostics, experts from Ghana, Tunisia, and Germany showcased real progress: accurate, field-deployable workflows that don’t depend on electricity, cold chains, or centrifuges. At the heart of many of these workflows? The SwiftX™ rapid DNA extraction platform.

Chapter 1: Ghana’s Diagnostic Labyrinth — A View from the Ground

Dr. Richard Akuffo – Noguchi Memorial Institute for Medical Research

In Ghana, diagnosis often starts — and stops — with clinical judgment. Frontline health workers assess lesions by eye. But most have never seen confirmed cases of yaws or Buruli ulcer. Misdiagnosis is common. Tools are scarce.

“Diagnosis without treatment is pointless. But treatment without local diagnosis is impossible.”
— Dr. Akuffo

The Reality:

• Ghana is endemic for 7 of 11 WHO-listed skin NTDs, yet point-of-care diagnostics are largely unavailable.

• Cutaneous leishmaniasis is confirmed only via PCR at reference centers.

• Scabies is diagnosed clinically, without dermoscopy or lab support.

• Yaws relies on DPP® serology, with confirmatory PCR often delayed or unavailable.

The Result:

• Delayed care, reliance on traditional medicine, and patients lost to follow-up.

Scientific Challenge: Can we deliver species-specific, immediately actionable diagnostics that fit into the real constraints of rural clinics?

Chapter 2: Tracking Leishmaniasis Through Climate and Conflict

Dr. Insaf Belhadj Ali – Institut Pasteur de Tunis

Cutaneous leishmaniasis (CL) doesn’t play by the rules. In Tunisia, Morocco, and Lebanon, the usual geographic separation between species is collapsing. Now Leishmania major, tropica, and infantum co-circulate — driven by displacement, warming climates, and changing vector patterns.

“CL is the great imitator. And treatment only works when we know what we’re treating.”
— Dr. Belhadj Ali

Tools Developed:

RPA + Lateral Flow

• Detects: L. major, L. infantum, L. tropica

• Workflow: 45 min (40 min isothermal amplification + 5 min dipstick readout)

• Sensitivity: As low as 5 parasites (L. major), ~60% (L. tropica)

• Specificity: Up to 100%

Duplex PCR with Visual Strip Readout

• Time: <30 min (18 min amplification + 10 min detection)

• Species Logic:

  • Line 1 = L. major

  • Line 2 = L. infantum

  • Both lines = L. tropica

• Limit of Detection: 8 parasites in blood samples

• No human DNA cross-reactivity

The Twist: DNA extraction was the limiting step — until they piloted SwiftX™.

SwiftX™ Results:

• 100% detection from CL-positive slides

• 3 additional positives missed by microscopy

• Extraction in <30 minutes, no centrifuge, cold chain, or column kits

Scientific Takeaway: Accurate, species-level detection is now viable in low-resource clinics. The last barrier? Fast, field-friendly DNA prep — and it’s being solved.

Chapter 3: Buruli Ulcer and the Power of 30-Minute Extraction

Dr. Andy Wende (Xpedite Diagnostics) & Dr. Tamás Surján (LMU Munich)

Buruli ulcer, caused by Mycobacterium ulcerans, is a diagnostic nightmare. Its tough, waxy cell wall resists lysis, and confirming infection via IS2404 qPCR traditionally takes 12+ hours. So LMU and Xpedite Diagnostics set out to simplify it — radically.
 

Study Design:

• 200 mock clinical samples spiked with ~4,000 M. ulcerans cells

• DNA extracted via:

  • Puregene (gold standard, lab-based)

  • Genolyse (heat + centrifuge)

  • SwiftX™ workflows (bead capture + heat lysis + reverse purification)

Results Snapshot:

• Ct values within ±1 cycle of gold standard

• Compatible with both IS2404 qPCR and LAMP

• No cold chain, no moving parts, low-cost (~1.50€ per sample)

Scientific spark: If the most extraction-resistant pathogen in skin NTDs can be prepped in 22 minutes without a lab — what else can we unlock?

Why It Matters

These aren’t future technologies. They’re working solutions — piloted, tested, and ready to scale. And they mark a turning point.

The stakes are high:

• Treatment decisions depend on species-specific diagnostics.

• Public trust in health systems hinges on speed and accuracy.

• NTD elimination goals rely on last-mile surveillance capacity.

But to scale these tools, we need:

• More pilot deployments across endemic regions

• Lyophilized, room-temp reagents

• Training programs for frontline health workers

• Collaboration across ministries, NGOs, and industry
   

Learn More or Try It Yourself

Ready to bring molecular diagnostics to the front lines of skin NTD control?

• Watch the full webinar recording (here)
• Consult our bacteriology resources (here)
• Consult our Leishmaniasis resources (here)
• Download protocols or request a demo kit (here)
• Contact our team to learn more about Xpedite solutions and request a demo: info@xpedite-dx.com

Xpedite Diagnostics is already helping break the bottlenecks of diagnosis. Partner with us!