Leiden University Scholarly Publications

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Pierneef, L. (2026)

Field-deployable immunodiagnostics for poverty-associated infectious diseases: development and use cases in public health

Doctoral Thesis
This thesis explores the development, validation, and implementation of field-deployable immunodiagnostic tools for poverty-associated infectious diseases, with a primary focus on leprosy and additional applications for tuberculosis (TB). Using upconverting phosphor lateral flow assay (UCP-LFA) technology, quantitative rapid tests were developed and evaluated for use in resource-limited settings.
The research combines technological innovation with large-scale field studies to assess the potential of these tools for surveillance, (adjunct) diagnosis, and monitoring of public health interventions. Particular emphasis is placed on the detection of Mycobacterium leprae (M. leprae) infection through measurement of anti-PGL-I antibodies. Serological surveys conducted among school-aged children in India and Indonesia investigated the use of seroprevalence as an indicator of recent/ongoing transmission. In addition, large-scale implementation within the PEOPLE trial in the Comoros and...Show moreThis thesis explores the development, validation, and implementation of field-deployable immunodiagnostic tools for poverty-associated infectious diseases, with a primary focus on leprosy and additional applications for tuberculosis (TB). Using upconverting phosphor lateral flow assay (UCP-LFA) technology, quantitative rapid tests were developed and evaluated for use in resource-limited settings.
The research combines technological innovation with large-scale field studies to assess the potential of these tools for surveillance, (adjunct) diagnosis, and monitoring of public health interventions. Particular emphasis is placed on the detection of Mycobacterium leprae (M. leprae) infection through measurement of anti-PGL-I antibodies. Serological surveys conducted among school-aged children in India and Indonesia investigated the use of seroprevalence as an indicator of recent/ongoing transmission. In addition, large-scale implementation within the PEOPLE trial in the Comoros and Madagascar evaluated the feasibility of integrating quantitative rapid testing into public health programmes aimed at reducing M. leprae transmission.
Beyond leprosy, the thesis examines the application of host biomarker-based assays for distinguishing active from latent TB and for differentiating TB from COVID-19. Overall, the findings demonstrate the potential of quantitative immunodiagnostics to strengthen infectious disease control and surveillance in endemic settings.
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Mycobacterium leprae infection
Point-of-care diagnostics
Anti-M. leprae PGL-I antibodies
UCP-LFA
Quantitative
Children
Serosurvey
Transmission
Tuberculosis
Host biomarkers
All authors
Pierneef, L.
Supervisor
Geluk, A.
Co-supervisor
Corstjens, P.L.A.M.
Committee
Visser, L.G.; Lieshout, E.A. van; Diehl, J.C.; Hasker, E.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2026-09-10